经内镜逆行胰胆管造影术后急性胰腺炎与高淀粉酶血症的临床分析及乌司他丁的预防作用

摘要

目的：分析经内镜逆行胰胆管造影（ERCP）术后急性胰腺炎与高淀粉酶血症的发生率并探讨乌司他丁对其的预防作用。方法：无乌司他丁干预的52例与乌司他丁干预的142例接受 ERCP 术患者分别作为对照组与观察组，分别计算两组患者 ERCP 术后急性胰腺炎及高淀粉酶血症发生率并进行对比分析，同时对比两组患者术前、术后不同时间血清淀粉酶水平。结果：对照组术后急性胰腺炎发生率为15．4％，高淀粉酶血症发生率为44．2％，均显著高于观察组的2．8％和22．5％（P ＜0．01）；两组患者术前血清淀粉酶水平比较无统计学差异（P ＞0．05），术后均明显增高（P ＜0．01），且术后各时间点观察组均显著低于对照组（P ＜0．01）。结论：ERCP 在多种胆道、胰腺疾病中取得了良好诊断与治疗效果，但术后急性胰腺炎以及高淀粉酶血症发生率较高，术后乌司他丁治疗能够有效降低术后急性胰腺炎与高淀粉酶血症的发生率。%Objective:To discuss the incidence and the preventive measure of acute pancreatitis and hyperamylasemia after ER-CP.Methods:52 patients without intervention of ulinastatin treated with ERCP were divided into the control group,and 142 patients with intervention of ulinastatin treated with ERCP were divided into the observation group,then the incidence of acute pancreatitis and hyperamylasemia after ERCP were caclated and contrasted,and the serum amylase level were contrasted between the two groups at dif-ferent times.Results:The incidence of acute pancreatitis and hyperamylasemia after ERCP in the control group were 15.4% and 44. 2%,significantly higher than 2.8% and 22.5% in the observation group(P <0.01 ).There was no significantly difference in the serum amylase level before ERCP(P >0.05),but significantly reduced after ERCP in the two groups(P <0.01 ),and the observation group was significantly lower than the control group(P <0.01 ).Conclusion:ERCP achieves better diagnosis and treatment effect in a variety of biliary and pancreatic diseases,but the incidence of acute pancreatitis and hyperamylasemia are high;ulinastatin can effectively re-duce the incidence of postoperative acute pancreatitis and hyperamylasemia.