孙富强 邹多武 李兆申 许国铭 孙振兴 孙富强(孙富强为进修生，现在山东省微山县医院，邮编277600)；邹多武 李兆申 许国铭 孙振兴(200433 上海，第二军医大学长海医院消化内科) 中华消化内镜杂志 2000 0 17 2


    关键词：内镜逆行胰胆管造影术；胰腺炎；淀粉酶 期刊 zhxhnjzz 0 81-83 论著 fur -->


    

【摘要】目的评价西咪替丁对经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预防作用。方法将414例患者随机分为A、B、C三组，A组(158例)分别于术前一日、当日及术后一日给予西咪替丁(800mg/d，静脉滴注)，B组(147例)分别于术前30min及术后4h内给予生长抑素类似物奥曲肽0.1mg皮下注射，C组(109例)给予安慰剂。术前、术后3h及24h检测血清淀粉酶(正常参考值10～120U/L)及肝、肾功能。结果A组有5例(3.16%)、B组4例(2.72%)和C组9例(8.30%)发生急性胰腺炎(A组与C组比较，P<0.05；B组与C组比较，P<0.05；A组与B组比较，P>0.05)。A组有39例(24.70%)、B组37例(25.17%)和C组58例(53.21%)发生高淀粉酶血症(A组与C组比较，P<0.01；B组与C组比较，P<0.01；A组与B组比较，P>0.05)。结论西咪替丁与奥曲肽一样能有效地预防ERCP术后高淀粉酶血症及急性胰腺炎的发生。

Prevention of ERCP from pancreatitis

SUN Fuqiang, ZOU Duowu, LI Zhaoshen, et al.

    ( Department of Gastroenterology, Changhai Hospital, Second Millitary Medical University, Shanghai 200433, China )

【 Abstract 】 Objective The preventive effect of cimetidine on post - ERCP pancreatitis and hyperamylasemia was investigated. Methods 414 patients who underwent ERCP were divided at random into 3 groups; group A (n=158) receiving perioperative intravenous cimetidine, 800mg/day for 3 days; group B (n=147) having hypodermic octreotide, 0.1mg, 30 minutes before and 4 hours after ERCP; group C (n=109) being given boluses of placebo. Blood was drawn in each group the day before, 3 hours and 24 hours following ERCP for amylase and hepatorenal functions. Results Post - ERCP pancreatitis ensued in 5 (3.16 % ) cases of group A; in 4 (2.72 % ) of B and 9 (8.30 % ) of C (P<0.05 when A vs C and B vs C; P>0.05 while A vs B). Hyperamylasemia occurred in 39 (24.70 % ) instances of group A, in 37 (25.17 % ) of B and 58 (53.21 % ) of C, (P<0.01 as A vs C and B vs C, whereas P>0.01 as A vs B). Conclusion Cimetidine exerts the same preventive effect as octreotide on ERCP against pancreatitis and hyperamylasemia.

     【 Key words 】 ERCP ; Pancreatitis ; Amylase

随着内镜逆行胰胆管造影(ERCP)广泛应用于胆胰疾病的诊断 ......

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