目的 观察氟比洛芬酯对内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)术后胰腺炎的预防作用。方法 选择2014-01至2016-12收治的胰胆管疾病行ERCP患者110例,随机均分为氟比洛芬酯组(56例)和对照组(54例)。氟比洛芬酯组麻醉前给予氟比洛芬酯1.5 mg/kg,对照组给予同等剂量生理盐水。术前,术后6 h、12 h抽取患者静脉血,检测血中胰淀粉酶含量,并记录两组患者术后6 h、24 h发生高淀粉酶血症和术后发生胰腺炎的情况。结果 两组患者血清胰淀粉酶水平在术前相比差异无统计学意义;术后6 h氟比洛芬酯组血清胰淀粉酶水平(225±67.83) U/L相较对照组(379±112.61)U/L明显降低(P＜0.05); 术后24 h氟比洛芬酯组血清胰淀粉酶水平减少(127±92.77) U/L相较对照组(186±97.28) U/L降低(P＜0.05)。术后6 h氟比洛芬酯组高淀粉酶血症发生率为14.9%(8/56例),低于对照组的35.19%,术后24 h氟比洛芬酯组高淀粉酶血症发生率为5.36%(3/56例),低于对照组的20.37%(P＜0.05);两组患者胰腺炎的发生情况氟比洛芬酯组为0,相较对照组的11.1%有统计学差异(P＜0.05)。结论 氟比洛芬酯可降低ERCP术后血清胰淀粉酶血水平,减少ERCP术后胰腺炎的发生。
Abstract
Objective To investigate the role of flurbiprofen axetil in preventing post-ERCP pancreatitis(PEP) in patients after endoscopic retrograde cholangiopancreatography(ERCP).Methods One hundred and ten ASA Ⅰ or Ⅱ patients who had received ERCP were randomly assigned to the group of intravenous injection of 1.5 mg/kg flurbiprofen axetil (flurbiprofen group) and saline alone (placebo group). The serum amylase was detected 6 and 24 h after operation,while the incidence of PEP and postoperative hyperamylasemia was compared between the two groups.Results The serum amylase level in flurbiprofen group was significantly lower than that in control group 6 h and 24 h after ERCP [(225±67.83) U/L vs (379±112.61) U/L,(127±92.77) U/L vs (186±97.28) U/L](P＜0.05). 11.1%(6/54) of the patients in control group had PEP compared with 0.0%(0/56)in flurbiprofen group. 35.19%(19/54) of the patients in control group and 14.9%(8/56)in flurbiprofen group had hyperamylasemia 6 h after ERCP,and the incidence of hyperamylasemia was 20.37%(11/54)in control group and 5.36%(3/56)in flurbiprofen group 24 h after ERCP, so there was significant difference between the two groups(P＜0.05).Conclusions Flurbiprofen axetil is an effective, safe and easy method for prevention of PEP.
关键词
氟比洛芬酯 /
内镜逆行胰胆管造影术 /
高淀粉酶血症 /
术后胰腺炎
Key words
flurbiprofen axetil /
endoscopic retrograde cholangiopancreatography /
hyperamylasemia /
post-ERCP pancreatitis
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