高浓度硫酸镁预防经内镜逆行胰胆管造影术后胰腺炎和高淀粉酶血症的效果

目的探讨经内镜逆行胰胆管造影（ERCP）操作结束前喷洒高浓度硫酸镁对预防术后胰腺炎（PEP）和高淀粉酶血症的临床效果。方法将收治的148例行ERCP手术患者随机分为观察组与对照组各74例,对照组进行ERCP手术,不采用硫酸镁处理,观察组于ERCP操作结束前采用33%的硫酸镁对十二指肠乳头局部进行喷洒处理,比较两组高淀粉酶血症及PEP的发生率。结果两组患者术后4 h、术后12 h、术后24 h的血淀粉酶水平比较差异有统计学意义（P〈0.01）;观察组术后4 h、术后12 h及术后24 h的血淀粉酶水平均显著低于对照组同期水平（P〈0.01）,观察组高淀粉酶血症及PEP的发生率均显著低于对照组（P〈0.05或0.01）。结论 ERCP操作结束前喷洒高浓度硫酸镁可有效降低术后胰腺炎及高淀粉血症的发生率,值得临床推广应用。

Clinical efficacy of spraying high concentration of magnesium sulfate in the prevention of pancreatitis and hyperamylasemia before the end of ERCP

Objective To explore the clinical efficacy of spraying high concentration of magnesium sulfate in the prevention of postoperative pancreatitis（ PEP） and hyperamylasemia before the end of ERCP. Methods 148 patients underwent ERCP were randomly divided into observation group and control group with 74 patients in each group. The control group underwent ERCP without using magnesium sulfate. And the observation group were sprayed by magnesium sulfate with concentration of 33% for local duodenal papilla before the end of ERCP. Then,incidence of PEP and hyperamylasemia of the two groups were compared. Results Difference in serum amylase levels of the two groups 4 hours later,12 hours later and 24 hours later after operation was statistically significant（ P〈0. 01）; the serum amylase levels of the observation group 4 hours later,12 hours later and 24 hours later after operation were all significantly lower than those of the control group in the same periods（ P〈0. 01）,and the incidences of PEP and hyperamylasemia were significantly lower than those of the control group（ P〈0. 05 or 0. 01）. Conclusion To spray high concentration of magnesium sulfate before the end of ERCP can effectively reduce the incidence of postoperative pancreatitis and hyperamylasemia. Thus,it is worthy of application and popularization in clinic.