奥曲肽联合泮托拉唑预防内镜逆行胰胆管造影术后胰腺炎

目的：探讨内镜逆行胰胆管造影（ERCP）术后胰腺炎的预防措施。 方法：将2010年7月—2012年11月间行ERCP术后的患者100例，随机分为观察组和对照组，每组各50例患者。观察组术后给予联合应用生长抑素（奥曲肽0.1 mg/8 h皮下注射连用24 h）和质子泵抑制剂作预防治疗（泮托拉唑40 mg/d静脉滴注连用2 d），对照组给予生理盐水静脉滴注。比较两组患者ERCP术后3，12，24 h的血清淀粉酶情况，及胰腺炎的发生情况。 结果：两组一般资料比较具有可比性；在术后3，12，24 h各时间点比较，观察组血清淀粉酶水平均明显低于对照组（均P<0.05）；观察组术后12，24 h高淀粉酶血症发生率及术后急性胰腺炎明显均低于对照组（18% vs. 42%；8% vs. 22%；2% vs. 16%）（均P<0.05）。 结论：联合应用生长抑素和质子泵抑制剂可减少ERCP术后高淀粉酶血症与胰腺炎的发生率，是一种安全且有效的ERCP术后胰腺炎预防措施。

Octreotide plus pantoprazole for prevention of post-ERCP pancreatitis

Objective: To investigate the preventive measures of acute pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP). Methods: Within the period of July 2010 to November 2012, 100 patients undergoing ERCP were randomly designated to observation group or control group with 50 cases in each group. After ERCP procedure, the patients in observation group received the combination treatment of somatostatin (octreotide 0.1 mg/8 h subcutaneous injection for 24 h) and proton pump inhibitor (pantoprazole 40 mg/d intravenous drip for 2 d), while those in control group were given normal saline instead. The serum levels of amylase at 3, 12 and 24 h after ERCP, and incidences of post-ERCP acute pancreatitis between the two groups were compared. Results: The general data between the two groups were comparable. The serum levels of amylase in observation group at 3, 12 and 24 h after ERCP were all significantly lower than those in control group (all P<0.05). The incidences of hyperamylasemia at 12 and 24 h after ERCP and post-ERCP acute pancreatitis in observation group were all significantly lower than those in control group (18% vs. 42%; 8% vs. 22%; 2% vs. 16%) (all P<0.05). Conclusion: The combination use of somatostatin and proton pump inhibitor can reduce the incidences of post-ERCP hyperamylasemia and pancreatitis, so it is safe and effective for prevention of post-ERCP pancreatitis.