奥美拉唑预防逆行胰胆管造影术后急性胰腺炎的临床研究

目的 探讨奥美拉唑对诊断及治疗性逆行胰胆管造影(ERCP)引发急性胰腺炎的预防作用.方法 126例患者按检查顺序随机分为奥美拉唑组和安慰剂组,分别在ERCP术前2天及当天口服奥美拉唑20 mg及复合维生素B2片,每日2次.术前及术后4.24 h分别测定血清淀粉酶及肝肾功能,并对腹痛等症状进行评价.结果 术后奥美拉唑组无急性胰腺炎的发生,而安慰剂组则有1例(1.59%)发生轻型胰腺炎;术后4.24 h奥美拉唑组分别有13例(20.63%)、5例(7.93%)发生一过性高淀粉酶血症,安慰剂组则分别有19例(30.16%)、9例(14.29%)发生一过性高淀粉酶血症.奥美拉唑组ERCP术后急性胰腺炎发生率及术后4 h高淀粉酶血症发生率均明显低于安慰剂组,(P<0.01、P<0.05);两组术后24 h血清淀粉酶水平差异无统计学意义(P>0.05).结论 奥美拉唑对ERCP引发的急性胰腺炎有一定的预防作用.

Clinical study on Omeprazole in prevention of acute pancreatitis induced by endoscopic retrograde choledo-chopancreatography

Objective To study the preventive effect of Omeprazole on post-endoscopic retrograde choledo-chopallcreatography(ERCP)-induced pancreatitis.Methods 126 patients were divided into two groups at random.One group received Omeprazole 20mg bid for two days.and the other group received placebo(Vitamine B).Blood was drawn in each group the day before,4 hours and 24 hours following ERCP for examination of amylase and hepa-torenal functions.Meanwhile Meanwhile the clinical manifestations of acute pancreatitis were also observed.Results Acute pancreatitis was clinically induced in 1.59% cases of placebo group,but none in the Omeprazole group.Hyperamy-lasemia occurred in 20.63%-7.93%in Omeprazole group at 4 hours and 24 hours after ERCP operation,while 30.16%.14.29%in placebo group;The incidence rate of acute pancreatitis following ERCP and hyperamylasemia 4 h after ERCP in omeprazole group were significantly lower than in placebo group(P<0.01,P<0.05).There were no significance differences in amylase 24 hours following ERCP between two groups(P>0.05).Concluslon Omeprazole can prevent the acute pancreatitis induced by ERCP to some extent.