法莫替丁预防内镜逆行胰胆管造影术后胰腺炎的临床研究--附46例报告

目的 :探讨法莫替丁预防内镜逆行胰胆管造影 (endoscopicretrogradecholangiopan creatography ,ERCP)术后急性胰腺炎的作用。方法 :86例胆胰疾病患者分为法莫替丁组 4 6例和安慰剂组4 0例 ,分别在ERCP术前 1日和当日静脉滴注生理氯化钠 5 0 0mL加法莫替丁 2 0mg和单纯生理氯化钠 5 0 0mL ,每日 2次。术前、术后 4小时及 2 4小时分别测定血清淀粉酶并观察有无急性胰腺炎的临床表现如腹痛、呕吐、发热等。结果 :ERCP术后法莫替丁组及安慰剂组急性胰腺炎的发生率分别为 7% (3/ 4 6 )、13% (5 / 4 0 ) ,P <0 0 1;术后 4小时高淀粉酶血症的发生率分别为 30 % (14 / 4 6 )、 4 8% (19/ 4 0 ) ,P <0 0 5。术后 2 4小时两组血清淀粉酶水平差异无统计学意义。结论 :法莫替丁可减少ERCP术后急性胰腺炎的发生率

Prevention of acute pancreatitis induced by endoscopic retrograde cholangiopancreatography with famotidine

Objective:To investigate the preventive effect of famotidine on acute pancreatitis and hyperamylasemia induced by diagnostic and/or interventional endoscopic retrograde cholangiopancreatography (ERCP). Methods:Eighty-six patients were divided into famotidine and placebo groups. Famotidine group received perioperative intravenous injection of 20 mg famotidine twice a day for two days and the placebo group received intravenous injection of normal saline. Blood was drawn in each group the day before, 4 hours and 24 hours following ERCP for amylase measurement. Clinical manifestations of acute pancreatitis were also observed. Results:Acute pancreatitis was clinically established in 7% of famotidine group, significantly lower than that of placebo group(13%,P<0.01);Hyperamylasemia occurred in 30% patients of famotidine group and 48% of placebo group at 4 hours post-ERCP (P<0.05);There was no significant difference in amylase 24 hours following ERCP between the two groups. Conclusion:Famotidine can prevent acute pancreatitis and hyperamylasemia induced by diagnostic and/or interventional ERCP.