摘要
目的探讨盐酸消旋山莨菪碱在胆总管结石经ERCP治疗中的应用效果。方法法按回归性研究原则,选择2018年1月至2023年1月在新疆医科大学第四附属医院以胆总管结石经ERCP治疗的427名患者,随机分为观察组(214例)与对照组(213例)。两组胆总管结石患者均行ERCP取石治疗,其中观察组术前常规使用盐酸消旋山莨菪碱注射液,对照组未使用盐酸消旋山莨菪碱及其他解痉药物,对比两组患者术中oddi括约肌插管情况、术中出血量,术后临床指标及并发症发生情况。结果两组患者术后均未出现严重出血、穿孔或病死,术后总胆红素、AST、ALT及炎症指标(白细胞、中性粒细胞绝对值、淋巴细胞绝对值)、术后胆道感染、出血、消化道穿孔等并发症发生率差异无统计学意义(P>0.05)。与使用盐酸消旋山莨菪碱组相比,未使用盐酸消旋山莨菪碱组插管困难人数、术中胰腺管插管次数、术中出血量、术后血淀粉酶水平、术后急性胰腺炎(PEP)、高淀粉酶血症发生率更高,术后住院时间更长,差异有统计学意义(P<0.05)。结论术前常规使用盐酸消旋山莨菪碱降低插管难度,减少胰管插管,减少术中出血量、降低术后血清淀粉酶水平及术后急性胰腺炎(PEP)、高淀粉酶血症的发生,缩短术后住院时间,具有良好的临床价值。
Objective To analyze the effect of Raceanisodamine in the treatment of common bile duct undergoing ERCP.Methods According to the principle of regression study,427 patients treated with ERCP for choledocholithiasis in the Fourth Affilia-ted Hospital of Xinjiang Medical University from January 2018 to January 2023 were selected and randomly divided into observation group(214 cases)and control group(213 cases).Patients with choledocholithiasis in both groups were treated with ERCP.The ob-servation group received Raceanisodamine injection before surgery,while the control group did not receive Raceanisodamine and other spasmolytic drugs.The intraoperative oddi sphincter intubation,intraoperative blood loss,postoperative clinical indicators and compli-cations of the two groups were compared.Results There was no serious hemorrhage,perforation or death between the two groups.There was no significant difference in the incidence of postoperative complications such as total bilirubin,AST,ALT and inflammatory indicators(absolute values of leukocytes,neutrophils and lymphocytes),postoperative biliary tract infection,hemorrhage and digestive tract perforation(P>0.05).Compared with the racemic anisodamine group,the number of intubation difficulties,the number of intra-operative pancreatic tube intubation,intraoperative blood loss,postoperative blood amylase level,postoperative acute pancreatitis(PEP),and hyperamylasemia in the non-racemic group were higher,and the postoperative hospital stay was longer,with statistical significance(P<0.05).Conclution The use of Racanisodamine before surgery has good clinical value in reducing the difficulty of in-tubation,reducing pancreatic duct intubation,reducing intraoperative blood loss,reducing postoperative serum amylase level,and re-ducing postoperative acute pancreatitis(PEP)and hyperamylasemia,and shortening postoperative hospital stay.
作者
阿布都喀哈尔·阿布都拉
哈力木拉提·吾布力卡斯木
段绍斌
ABUDUKAHAER Abudu;HALIMULATIt Obulkasim;DUAN Shao Bin(The filiatedl Hospital of Tradional Chinese Medicine of Xinjiang Medical University Urumqi 830000,China)
出处
《肝胆外科杂志》
2024年第2期108-111,共4页
Journal of Hepatobiliary Surgery
基金
天山青年计划青年博士科技人才培养项目(2020Q088)。
关键词
胆总管结石
内镜逆行胰胆管造影术
盐酸消旋山莨菪碱
并发症
commonbileductstones
endoscopic retrograde cholangiopancreatography
raceanisodamine
postoperative complica-tions
