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目的探讨奥曲肽对内镜下逆行胰胆管造影(ERCP)术后急性胰腺炎(AP)及高淀粉酶血症的防治作用。方法214例ERCP+十二指肠乳头切开取石术(EST)患者随机分为2组:预防组122例,于ERCP术前30min及术后4h分别予奥曲肽0.1mg皮下注射;对照组92例,术前、术后均不使用奥曲肽。2组术后如发生AP则按AP处理。分别测定术前及术后6、24h血清淀粉酶,同时观察AP发生情况,并比较2组的医疗费用。结果预防组术后6、24h血清淀粉酶分别为(233.2±70.8)、(198.5±79.8)U/dl,均低于对照组的(487.9±189.0)、(412.4±158.3)U/dl(P<0.01);预防组与对照组术后发生AP分别为2例(1.6%)、6例(6.5%);术后24h高血淀粉酶血症分别为36例(29.5%)、40例(43.5%)(P<0.05)。预防组与对照组平均医疗费用分别为12076元及11829元。结论奥曲肽对ERCP术后AP及高淀粉酶血症有预防作用;ERCP预防性使用奥曲肽未明显增加患者医疗费用。
Objective To investigate the preventive and therapeutic effects of octreotide on acute pancreatitis (AP) and hyper amylasemia after endoscopic retrograde cholangiopancreatography (ERCP). Methods 214 patients with ERCP + duodenal papillae excision (EST) were randomly divided into two groups: prevention group (n = 122), subcutaneous injection of 0.1 mg octreotide at 30 min before operation and 4 h after operation, 92 patients in control group No preoperative, postoperative octreotide. The AP group was treated with AP after surgery. Serum amylase was measured before and 6 and 24 hours after operation, and the incidence of AP was observed. The medical costs of the two groups were also compared. Results The levels of serum amylase at 6 and 24 hours after operation in the prophylaxis group were (233.2 ± 70.8) and (198.5 ± 79.8) U / dl, respectively, which were lower than those in the control group (487.9 ± 189.0 and 412.4 ± 158.3) U / dl <0.01). There were 2 cases (1.6%) and 6 cases (6.5%) of AP in the prevention group and the control group, respectively. The hypermyloemysplasia in the prevention group was 36 cases (29.5% 43.5%) (P <0.05). Prevention group and control group average medical costs were 12,076 yuan and 11,829 yuan. Conclusion The results showed that octreotide had preventive effect on AP and hyper amylase after ERCP. The preventive use of octreotide for ERCP did not significantly increase the medical cost of patients.