间苯三酚对胆总管结石患者内镜逆行胰胆管造影术术后血清胆红素及肿瘤坏死因子α的影响

摘要

目的 分析间苯三酚对内镜逆行胰胆管造影术(ERCP)术后胆总管结石患者血清胆红素及肿瘤坏死因子α的影响.方法 选取2011年3月至2015年3月唐山市人民医院收治的108例胆总管结石患者为研究对象,采用抽签法分为间苯三酚组和基础治疗组,各54例.两组患者行ERCP取石术后,基础治疗组给予西咪替丁(口服,每次2片,每日2次)+罗红霉素(口服,每次1片,每日2次),间苯三酚组在基础治疗组的基础上给予间苯三酚治疗(40 mg,静脉滴注,每日1次,连用3 d).观察比较两组患者治疗前、治疗后1 d以及治疗后3 d血清总胆红素、直接胆红素、间接胆红素、肿瘤坏死因子α水平的变化,以及并发症发生情况.结果 两组患者血清总胆红素、直接胆红素、间接胆红素以及肿瘤坏死因子α水平的组间、时点间和组间·时点间的交互作用比较,差异均有统计学意义(P<0.05),两组患者的以上各指标水平随治疗的进行,逐渐降低,而且间苯三酚组较基础治疗组更低;间苯三酚组患者的并发症发生率为1.8%(1/54),低于基础治疗组的27.8%(15/54)(P<0.05).结论 ERCP术后胆总管结石患者在常规抑酸、消炎补液治疗的基础上联合间苯三酚,能够降低患者体内血清总胆红素、直接胆红素、间接胆红素与肿瘤坏死因子α水平,同时也很大程度地降低并发症发生率.%Objective To analyze the effect of phloroglucinol on serum bilirubin and tumor necrosis factor α in patients with calculus of common bile duct of after endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 108 choledocholithiasis patients treated in Tangshan People's Hospital from Mar.2011 to Mar.2015 were selected,and the patients were divided into a phloroglucinol group and a basic treatment group according to lottery method,54 cases in each group.All the patients were treated with ERCP to have calculus removed,then the basic treatment group was given cimetidine(oral,2 tablets each time,2 times a day) and roxithromycin(oral,1 tablet each time,2 times a day),and the phloroglucinol group was treated with phloroglucinol(40 mg,intravenous infusion,1 time a day,continuously for 3 days)on the basis of the basic treatment group.The serum total bilirubin,direct bilirubin,indirect bilirubin,tumor necrosis factor α levels and the incidence of complications of the two groups were compared before treatment,after 1 d and 3 d of treatment.Results The serum total bilirubin,direct bilirubin,indirect bilirubin and tumor necrosis factor α of the two groups between groups,time points and groups·time points were statistically significantly different(P<0.05).The levels of serum total bilirubin,direct bilirubin,indirect bilirubin levels and tumor necrosis factor α of the two groups were reduced with the treatment prolong,and the phloroglucinol group was lower than the basic treatment group.The complications incidence of the phloroglucinol group was lower than that of the basic treatment group[1.8%(1/54) vs 27.8%(15/54)](P<0.05).Conclusion The phloroglucinol at the basis of conventional acid and anti-inflammatory fluid replacement therapy for common bile duct patients after ERCP can reduce the serum total bilirubin,direct bilirubin,indirect bilirubin and tumor necrosis factor-α level,and decrease the incidence of complications to a great extent.