生长抑素预防ERCP术后高淀粉酶血症及胰腺炎疗效的研究

目的探讨生长抑素预防性用药对内镜下逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography，ERCP）术后高淀粉酶血症及ERCP术后胰腺炎（post -ERCP pancreatitis，PEP）的作用。 方法纳入拟行ERCP治疗的280例患者，以生长抑素250 μg/h持续应用24 h，依据不使用生长抑素，术前1 h、术后即刻、术后3 h采用随机数字表分为四组。检测术前及术后5 h、24 h的血淀粉酶水平，观察和比较术后高淀粉酶血症、PEP的发生情况。 结果B、C、D组术后高淀粉酶血症和PEP发生率均显著低于A组，差异有统计学意义（P均＜0.05）。B、C、D组术后5 h、24 h血淀粉酶水平显著低于A组，差异有统计学意义（P＜0.05）。此外，B、C、D组间高淀粉酶血症、PEP发生率及术后血淀粉酶水平差异均无统计学意义（P＞0.05）。 结论预防性应用生长抑素可降低ERCP术后高淀粉酶血症及PEP的发生率，术前和术后3 h内用药的预防效果未见明显差别。

Effect of somatostatin in preventing hyperamylase and post-ERCP pancreatitis

ObjectiveTo investigate the function of somatostatin prophylactic treatment in patients with postoperative hyperamylasemia and post ERCP pancreatitis(PEP) after endoscopic retrograde cholangiopancreatography(ERCP).MethodsA total of 280 patients to be treated with ERCP were included and treated with somatostatin 250 μg/h for 24 h. According to no use of somatostatin, they were divided into four groups by random number table 1 h before surgery, immediately after surgery, and 3 h after surgery.Serum amylase levels were detected 5 and 24 hours before and after operation, and the occurrence of postoperative hyperamylase and PEP were observed and compared.ResultsThere was no significant difference in age, sex and operation among the groups. The incidence of postoperative hyperamylasemia in group B, C and D was significantly lower than that in group A(P＜0.05). The incidence of PEP in group B, C and D was significantly lower than that in group A, with statistically significant differences(P＜0.05). Serum amylase levels in group B, C and D were significantly lower than those in group A 5 h and 24 h after surgery(P＜0.05). In addition, there were no significant differences in the incidence of hyperamylasemia, PEP and postoperative blood amylase levels among groups B, C and D(P＞0.05).ConclusionThe prophylactic application of somatostatin can reduce the incidence of hyperamylase and PEP after ERCP, and there was no significant difference in the prophylactic effect between preoperative and postoperative administration within 3 h.