吲哚美辛预防ERCP术后胰腺炎的效果观察
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1.资料与方法
1.1一般资料
将2016年8月至2017年8月期间我院收治的72例胆总管结石ERCP术后患者随机分为观察组36例和对照组36例，纳入标准为ERCP前血清淀粉酶正常、可耐受十二指肠镜检查、年龄在18～80岁之间的患者。排除标准：合并有严重心、脑、肺、肾等疾患及凝血功能障碍等手术高危因素；合并肿瘤等恶性疾病；NSAIDs药物禁忌使用或过敏者；1周内使用过NSAIDs药物；既往胰腺炎病史；对头孢类、喹诺酮类抗生素、泛影葡胺等药物过敏。此方案通过医院伦理委员会批准。其中观察组男性20例，女性16例，年龄54～77岁，平均年龄（49．6±9．8）岁。对照组男性15例，女性21例，年龄53.75岁，平均年龄（51．9±12．2）岁。两组病患在年龄、性别等基本资料对比无差异（P>0．05），具有可比性。
吲哚美辛预防ERCP术后胰腺炎的效果观察
摘要：目的：探讨吲哚美辛预防内镜逆行胰胆管造影术（ERCP）后胰腺炎患者的疗效。方法：将2016年8月至2017年8月期间我院收治的72例胆总管结石ERCP术后患者随机分为观察组36例和对照组36例，观察组术前30min加用吲哚美辛100mg肛塞，对照组给予安慰剂栓剂，后两组均行ERCP术，观察术后两组胰腺炎发生率，采用Somogyi法检测两组术前及术后3、24h血清淀粉酶。结果：手术前，两组患者的血清淀粉酶无显著差异，P＞0.05。和对照组相比，观察组患者在术后3h和24h的血清淀粉酶显著较低，P＜0.05。就胰腺炎以及高淀粉酶血症发生来看，观察组上述两种疾病的发生率明显较低，P＜0.05。结论：吲哚美辛对患者ERCP术后急性胰腺炎具有预防作用，且具有便于使用、经济等优点，应用前景比较广泛。
关键词：内镜逆行胰胆管造影术；胰腺炎；吲哚美辛
Effect of indomethacin on prevention of postoperative pancreatitis in ERCP
Abstract：Objective：To investigate the efficacy of indomethacin in preventing pancreatitis after endoscopic retrograde cholangiopancreatography（ERCP）. Methods：72 cases of choledo cholithiasis treated in our hospital from August 2016 to August 2017 were randomly divided into 36 cases in observation group and 36 cases in control group. Before operation，the observation group was treated with 30min plus indomethacin 100mg anal plug，the control group was given a placebo suppository，and the latter two groups were treated with ERCP，and the incidence of two groups of pancreatitis in the two groups was observed after the operation，and Somo was adopted. Gyi method was used to detect serum amylase in two groups before operation and 3 and 24h after operation. Results：there was no significant difference in serum amylase between the two groups before operation（P > 0.05）. Compared with the control group，the serum amylase levels of the observation group were significantly lower than those of the control group 3H and 24h，P < 0.05. According to the incidence of pancreatitis and hyperamylase，the incidence of the above two diseases in the observation group was significantly lower than that in the observation group，P < 0.05. Conclusion：indomethacin has a preventive effect on acute pancreatitis after ERCP，and has the advantages of convenient use and economy，and has wide application prospects.
1.2方法
患者术前禁食12h，禁水6h，祛除影响造影检查物品。合并器官病变者需实施心电监护，术前吸氧，肌注盐酸呱替啶50mg，山莨菪碱10mg以及地西洋5mg，造影剂为碘佛醇50ml。观察组术前30min给予引哚美辛栓100mg肛塞，对照组给予安慰剂栓剂。患者口服利多卡因凝胶后取俯卧位，插入电子十二指肠镜（OlympusJF240型），找到十二指肠乳头，拉直镜身，逆行插管成功后，注入造影剂（30％欧乃派克），显示扩张胆管及结石影，然后通过取石网篮取石，最后用球囊导管对胆总管进行清理，并造影确认取净结石。所有患者术后采常规治疗方案，包括禁食、持续胃肠减压（抑酸）、液体治疗、使用抗生素等综合治疗。
Keywords：endoscopic retrograde cholangiopancreatography；pancreatitis；indomethacin
目前，内镜逆行胰胆管造影术由于有不用开刀、创伤小、手术时间短、并发症发生率低、可缩短住院时间等显著优点已经广泛用于胰胆管疾病的诊断与治疗，但由于受到患者本身条件及手术者操作技术等多方面因素的影响，ERCP术后可能会发生一些并发症，胰腺炎为ERCP术后常见的一种并发症。本研究通过我院行ERCP的患者应用吲哚美辛栓，对其预防胰腺炎的有效性和安全性进行评价，为临床应用提供依据。
1.1一般资料
将2016年8月至2017年8月期间我院收治的72例胆总管结石ERCP术后患者随机分为观察组36例和对照组36例，纳入标准为ERCP前血清淀粉酶正常、可耐受十二指肠镜检查、年龄在18～80岁之间的患者。排除标准：合并有严重心、脑、肺、肾等疾患及凝血功能障碍等手术高危因素；合并肿瘤等恶性疾病；NSAIDs药物禁忌使用或过敏者；1周内使用过NSAIDs药物；既往胰腺炎病史；对头孢类、喹诺酮类抗生素、泛影葡胺等药物过敏。此方案通过医院伦理委员会批准。其中观察组男性20例，女性16例，年龄54～77岁，平均年龄（49．6±9．8）岁。对照组男性15例，女性21例，年龄53.75岁，平均年龄（51．9±12．2）岁。两组病患在年龄、性别等基本资料对比无差异（P>0．05），具有可比性。
吲哚美辛预防ERCP术后胰腺炎的效果观察
摘要：目的：探讨吲哚美辛预防内镜逆行胰胆管造影术（ERCP）后胰腺炎患者的疗效。方法：将2016年8月至2017年8月期间我院收治的72例胆总管结石ERCP术后患者随机分为观察组36例和对照组36例，观察组术前30min加用吲哚美辛100mg肛塞，对照组给予安慰剂栓剂，后两组均行ERCP术，观察术后两组胰腺炎发生率，采用Somogyi法检测两组术前及术后3、24h血清淀粉酶。结果：手术前，两组患者的血清淀粉酶无显著差异，P＞0.05。和对照组相比，观察组患者在术后3h和24h的血清淀粉酶显著较低，P＜0.05。就胰腺炎以及高淀粉酶血症发生来看，观察组上述两种疾病的发生率明显较低，P＜0.05。结论：吲哚美辛对患者ERCP术后急性胰腺炎具有预防作用，且具有便于使用、经济等优点，应用前景比较广泛。
关键词：内镜逆行胰胆管造影术；胰腺炎；吲哚美辛
Effect of indomethacin on prevention of postoperative pancreatitis in ERCP
Abstract：Objective：To investigate the efficacy of indomethacin in preventing pancreatitis after endoscopic retrograde cholangiopancreatography（ERCP）. Methods：72 cases of choledo cholithiasis treated in our hospital from August 2016 to August 2017 were randomly divided into 36 cases in observation group and 36 cases in control group. Before operation，the observation group was treated with 30min plus indomethacin 100mg anal plug，the control group was given a placebo suppository，and the latter two groups were treated with ERCP，and the incidence of two groups of pancreatitis in the two groups was observed after the operation，and Somo was adopted. Gyi method was used to detect serum amylase in two groups before operation and 3 and 24h after operation. Results：there was no significant difference in serum amylase between the two groups before operation（P > 0.05）. Compared with the control group，the serum amylase levels of the observation group were significantly lower than those of the control group 3H and 24h，P < 0.05. According to the incidence of pancreatitis and hyperamylase，the incidence of the above two diseases in the observation group was significantly lower than that in the observation group，P < 0.05. Conclusion：indomethacin has a preventive effect on acute pancreatitis after ERCP，and has the advantages of convenient use and economy，and has wide application prospects.
1.2方法
患者术前禁食12h，禁水6h，祛除影响造影检查物品。合并器官病变者需实施心电监护，术前吸氧，肌注盐酸呱替啶50mg，山莨菪碱10mg以及地西洋5mg，造影剂为碘佛醇50ml。观察组术前30min给予引哚美辛栓100mg肛塞，对照组给予安慰剂栓剂。患者口服利多卡因凝胶后取俯卧位，插入电子十二指肠镜（OlympusJF240型），找到十二指肠乳头，拉直镜身，逆行插管成功后，注入造影剂（30％欧乃派克），显示扩张胆管及结石影，然后通过取石网篮取石，最后用球囊导管对胆总管进行清理，并造影确认取净结石。所有患者术后采常规治疗方案，包括禁食、持续胃肠减压（抑酸）、液体治疗、使用抗生素等综合治疗。
Keywords：endoscopic retrograde cholangiopancreatography；pancreatitis；indomethacin
目前，内镜逆行胰胆管造影术由于有不用开刀、创伤小、手术时间短、并发症发生率低、可缩短住院时间等显著优点已经广泛用于胰胆管疾病的诊断与治疗，但由于受到患者本身条件及手术者操作技术等多方面因素的影响，ERCP术后可能会发生一些并发症，胰腺炎为ERCP术后常见的一种并发症。本研究通过我院行ERCP的患者应用吲哚美辛栓，对其预防胰腺炎的有效性和安全性进行评价，为临床应用提供依据。