胰管支架预防高危患者逆行胰胆管造影术后胰腺炎

目的 探讨胰管支架置入在预防高危患者经内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）及高淀粉酶血症中的作用。方法 回顾性分析2013年1月至2014年12月间我院行ERCP治疗的160例PEP高危患者的临床资料。依据是否置入胰管支架，将其分为胰管支架组82例（放置支架）和对照组78例（未放置支架）。观察术后患者腹痛情况，监测术后3h、24h血清淀粉酶水平， 比较两组术后胰腺炎、高淀粉酶血症的发生率。结果 胰管支架组术后腹痛发生率、腹痛评分19.5% （16/82）、(1.24±0.58)]均低于对照组43.6%（34/78）、(1.68±0.97)]，差异有统计学意义（P=0.001）。胰管支架组术后3h和术后24h血清淀粉酶分别为（184.89±257.33）U/L和（268.07±344.73）U/L，均低于对照组（305.35±371.81）U/L和（465.86±639.94）U/L，差异有统计学意义（P<0.05）。胰管支架组急性胰腺炎、高淀粉酶血症发生率2.4%（2/82）、17.1%(14/82)]显低于对照组11.5%(9/78)、30.8%(24/78)]，差异有统计学意义（P<0.05）。结论 胰管支架置入可有效预防高危患者ERCP术后胰腺炎及高淀粉酶血症的发生。

Pancreatic duct stent preventing post endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients

Objective To evaluate the preventive effect of pancreatic duct stent against post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia in high-risk patients. Methods A total of 160 patients with high-risk PEP underwent ERCP therapy between Jan. 2013 and Dec. 2014 and were retrospectively analyzed. The patients were divided into pancreatic duct stent group (n=82) and control group (n=78) according to whether receiving pancreatic duct stent or not. Abdominal pain was evaluated after ERCP. The levels of serum amylase were detected at 3 h and 24 h after ERCP. The incidences of PEP and hyperamylasemia were compared between the two groups. Results The serum amylase levels at 3 h and 24 h after ERCP in pancreatic duct stent group were significantly lower than those in control group (184.89±257.33] U/L vs 305.35±371.81] U/L, P <0.05; 268.07±344.73] U/L vs 465.86±639.94] U/L, P <0.05). The incidences of PEP and hyperamylasemia in pancreatic duct stent group were also significantly lower than those in control group (2.4%2/82] vs 11.5%9/78], P <0.05;17.1%14/82] vs 30.8%24/78], P <0.05). The incidence of abdominal pain and abdominal pain score were (19.5%16/82], 1.24±0.58]) in pancreatic duct stent group, which were significantly lower than those in control group (43.6% 34/78], 1.68±0.97]) ( P =0.001). Conclusion Pancreatic duct stent can effectively prevent PEP and hyperamylasemia in high-risk patients following ERCP.