小剂量奥曲肽预防内镜逆行胰胆管造影术后高淀粉酶血症及急性胰腺炎的临床观察
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篇名: 小剂量奥曲肽预防内镜逆行胰胆管造影术后高淀粉酶血症及急性胰腺炎的临床观察
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摘要: 目的:观察小剂量奥曲肽预防内镜逆行胰胆管造影(ERCP)术后高淀粉酶血症及急性胰腺炎的临床效果及安全性。方法:选择2014年10月-2015年1月我院行ERCP的患者120例。按照随机数字表法分为观察组和对照组,各60例。两组患者术前0.5 h给予地西泮片10 mg+盐酸哌替啶片100 mg+苯巴比妥东莨菪碱片2片镇静和镇痛,以及常规的抑酸、抗感染治疗。观察组在此基础上给予醋酸奥曲肽注射液0.1 mg,皮下注射,并于术后即刻、术后8 h分别给予醋酸奥曲肽注射液0.1 mg,皮下注射。观察两组患者血清淀粉酶、血糖水平,记录术后并发症和不良反应发生情况。结果:术前,两组患者血清淀粉酶、血糖水平比较,差异无统计学意义(P>0.05)。术后,对照组患者血清淀粉酶水平明显高于观察组,差异均有统计学意义(P<0.05);两组患者血糖水平比较,差异无统计学意义(P>0.05);观察组患者术后高淀粉酶血症和不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05);而术后急性胰腺炎的发生率比较,差异无统计学意义(P>0.05)。结论:小剂量奥曲肽能有效降低患者术后的血清淀粉酶水平,降低ERCP术后患者并发高淀粉酶血症的发生率,且安全性好。
ABSTRACT: OBJECTIVE: To observe clinical effects and safety of small dose of octreotide for preventing hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP). METHODS: One hundred and twenty ERCP patients were selected from our hospital during Oct. 2014-Jan. 2015 and then divided in to observation group and control group in accordance with random number table, with 60 cases in each group. Both groups were given Diazepam tablet 10 mg+Meperidine hydrochloride tablet 100 mg+Phenobarbital scopolamine tablet 2 tablets 0.5 h before surgery for sedation and analgesia, and routine acid suppression and anti-infective therapy. Observation group was additionally given Octreotide acetate injection 0.1 mg hypodermically and then given Octreotide acetate injection 0.1 mg immediately after surgery, 8 h after surgery. The levels of serum amylase and blood glucose were observed in 2 groups, and the occurrence of postoperative complication and ADR were recorded. RESULTS: Before operation, there was no statistical significance in the levels of serum amylase and blood glucose between 2 groups (P>0.05). After operation, the level of serum amylase in control group was significantly higher than in observation group, with statistical significance (P<0.05). There was no statistical significance in blood glucose level between 2 groups after operation (P>0.05). The incidence of hyperamylasemia and ADR in observation group was significantly lower than in control group, with statistical significance (P<0.05), and there was no statistical significance in the incidence of acute pancreatitis between 2 groups after operation (P>0.05). CONCLUSIONS: Small dose of octreotide can effectively reduce the level of serum amylase and the incidence of hyperamylasemia after ERCP with good safety.
期刊: 2017年第28卷第8期
作者: 高改云,李静,樊宏伟,倪猛,孙晓
AUTHORS: GAO Gaiyun,LI Jing,FAN Hongwei,NI Meng,SUN Xiao
关键字: 奥曲肽;内镜逆行胰胆管造影;小剂量;高淀粉酶血症;急性胰腺炎
KEYWORDS: Octreotide; Endoscopic retrograde cholangiopancreatography; Small dose; Hyperamylasemia; Acute pancreatitis
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