加贝酯预防ERCP术后胰腺炎的临床研究

目的探讨加贝酯预防ERCP术后胰腺炎、胰性腹痛和高淀粉酶血症的疗效和安全性。方法按随机双盲法将拟行ERCP术的患者分为加贝酯组和对照组。加贝酯组患者在ERCP术前0．5h起开始静脉滴注加贝酯(300mg加入林格氏液500ml),维持4．5h。对照组则仅静脉滴注林格氏液500ml,也维持4．5h。结果共有94例患者完成研究,其中加贝酯组48例,对照组46例。加贝酯组有3例(6．3％)、对照组有9例(19．6％)患者发生了胰腺炎(P=0．040)；高淀粉酶血症的发生率两组分别为12例(25．0％)和21例(45．7％)(P=0．036)；胰性腹痛的发生率两组分别为5例(10．4％)和14例(30．4％)(P=0．016)。结论以加贝酯总量300mg持续4．5h静脉滴注(术前0．5h起给药)较安慰剂能有效减少ERCP术后胰腺炎发生率,减少高淀粉酶血症及胰性腹痛的发生。

Prophylactic effect of Gabexate on post-ERCP pancreatitis: a clinical observation

Objectives To examine the prophylactic effect of Gabexate on post-ERCP pancreatitis, hyperamylasemia and pancreatic pain. Methods Patients scheduled for ERCP were randomized to two groups: patients in Gabexate group were treated with continuous intravenous infusion of 300 mg gabexate dissolved in 500 ml Ringer's solution, starting 30 min before the endoscopic maneuvers and continuing for 4.5h after ERCP; placebo group patients were treated only with Ringer's solution for 4.5 h. Results A total of 94 patients enrolled in the final analysis. Post-ERCP pancreatitis occurred in 3 patients(6.3%) of Gabexate group and 9 patients(19.6%)of placebo group(P=0.040); hyperamylasemia occurred in 12 patients(25.0%) of Gabexate group and 21 patients(45.7%) of placebo group(P=0.036); and pancreatic pain occurred in 5 patients(10.4%) of Gabexate group and 14 patients(30.4%) of placebo group(P=0.016). Conclusions The results suggest that 4.5-h infusion of gabexate with a total dosage of 300 mg seems to prevent post-ERCP pancreatitis, hyperamylasemia and pancreatic pain effectively.