静脉滴注丹参注射液预防ERCP术后高淀粉酶血症及急性胰腺炎的临床研究

目的探讨丹参注射液预防内镜逆行胰胆管造影(ERCP)术后高淀粉酶血症及胰腺炎的临床疗效。方法将100例胆总管结石需行ERCP术患者,随机分为观察组50例和对照组50例,两组患者ERCP术后给予常规鼻胆引流、抗感染、抑制胰酶分泌等治疗,观察组于ERCP术前及术后1 d,给予丹参注射液250 mL,2次/d,静脉滴注。分别于术前、术后3 h、24 h检测两组患者的血淀粉酶、脂肪酶水平、术后24 h CRP。统计术后高淀粉酶血症、胰腺炎发生率。结果两组患者术后3 h、24 h血淀粉酶明显高于术前,但观察组术后3 h、24 h血淀粉酶低于对照组同期水平(P0.05);观察组患者高淀粉酶血症发生率为42%(21/50),术后胰腺炎发生率为0%(0/50),对照组高淀粉酶血症发生率为80%(40/50),术后胰腺炎发生率为8%(4/50)。结论丹参注射液对ERCP术后高淀粉酶血症、胰腺炎有一定的预防作用。

Clinical investigation of salvia miltiorrhiza in preventing and treating hyperamylasemia and acute pancreatitis following endoscopic retrograde cholangio pancreatography

Objective To observe the clinical effects of salvia miltiorrhiza in the prevention and treatment of hyperamylasemia and acute pancreatitis following endoscopic retrograde cholangio pancreatography（ ERCP）. Methods 100 patients with choledocholithiasis who underwent ERCP were randomly divided into control group and observation group,with 50 cases in each. Both groups were received routine therapy such as nasobiliary drainage,anti-infective medicine,inhibiting pancreatic secretion. The observation group was treated with salvia miltiorrhiza before ERCP and 1 day after operation,250 mL,twice a day,IV.The incidence of hyperamylasemia and pancreatitis,the level of serum amylase at 3h and 24 h after ERCP and the level of CRP at 24 h after ERCP were observed. Results The levels of serum amylase in both groups at 3 h and 24 h after ERCP were higher than that before operation,but the above indexes in the observation group were obviously lower than that in control group（ P〈 0. 05）, The hyperamylasemia（ 21 /50） and pancreatitis（ 0 /50） happened less frequently in the observation group（ 40 /50 and 4 /50,respectively）. Conclusions Salvia miltiorrhiza has some effects on reducing the incidence of hyperamylasemia and pancreatitis in patients undergoing ERCP.