术前肠道去污预防ERCP术后急性胰腺炎的前瞻性随机对照研究

摘要
图/表
参考文献(21)
相关文章 (15)

全文: PDF (0 KB) HTML (37 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨术前肠道去污对于预防内镜下逆行胰胆管造影术（ERCP）术后患者急性胰腺炎和高淀粉酶血症的疗效。方法选取2019年1月～2020年1月在我院进行ERCP 治疗的110 例患者作为研究对象，依据随机数字表法将入选对象分为试验组与对照组，每组各55 例。两组均行ERCP，试验组患者于术前晚七点口服复方聚乙二醇电解质散剂2000 ml 行肠道去污处理，对照组患者口服清水2000 ml。检测两组术前及术后24 h 的白细胞（WBC）、丙氨酸氨基转移酶（ALT）、血清总胆红素（TBil）水平，记录两组患者术后急性胰腺炎和高淀粉酶血症的发病率，比较两组患者的术后排便时间、腹痛评分、住院时间、医疗费用，观察两组患者住院期间的转归及其他并发症发生情况。结果两组患者术后24 h 的WBC、ALT、TBil 水平低于术前，差异有统计学意义（P＜0.05）；试验组患者术后24 h 的WBC、ALT、TBil 水平低于对照组，差异有统计学意义（P＜0.05）。试验组患者ERCP 术后急性胰腺炎和高淀粉酶血症发病率均低于对照组，差异有统计学意义（P＜0.05）。试验组患者的术后排便时间、住院时间短于对照组，腹痛评分低于对照组，医疗费用少于对照组，差异有统计学意义（P＜0.05）。试验组患者治愈出院率高于对照组，死亡率低于对照组，差异有统计学意义（P＜0.05）。试验组患者的感染、术后出血发生率低于对照组，差异有统计学意义（P＜0.05）。结论通过术前肠道去污可以减少ERCP 术后急性胰腺炎的发病率，减轻患者术后腹痛等不适，改善患者预后，降低医疗费用，值得临床应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	舒宏春
	练火军
	诸葛群
	周卫萍
	郑美虹
	邓辉球

关键词 ：术前肠道去污, 急性胰腺炎, 内镜下逆行胰胆管造影术, 高淀粉酶血症

Abstract：Objective To investigate the curative effect of preoperative intestinal decontamination on preventing acute pancreatitis and hyperamylasemia in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).Methods Altogether 110 patients who underwent ERCP in our hospital from January 2019 to January 2020 were selected as the study subjects. According to the random number table method, the subjects were divided into the experimental group and the control group, 55 cases in each group. ERCP was performed in both groups. The experimental group was given Compound Polyethylene Glycol Electrolyte Powder 2000 ml orally at 7 pm before operation, and the control group was given clear water 2000 ml orally.The levels of WBC,ALT and TBil were measured before and 24 hours after operation.The incidence of acute pancreatitis and hyperamylasemia was recorded between the two groups.The defecation time, abdominal pain score, hospitalization time and medical expenses were compared between the two groups.The prognosis during hospitalization and other complications were observed between the two groups. Results The levels of WBC, ALT and TBil at 24 hours after operation in the two groups were lower than those before operation, and the differences were statistically significant (P＜0.05). The levels of WBC, ALT and TBil 24 hours after operation in the experimental group were lower than those in the control group, with significant differences (P＜0.05). The incidence of acute pancreatitis and hyperamylasemia after ERCP in the experimental group was lower than that in the control group,with significant difference (P＜0.05). Postoperative defecation time and hospitalization time of the experimental group were shorter than those of the control group, abdominal pain score was lower than that of the control group, and medical expense was lower than that of the control group, with significant differences (P＜0.05). The cure discharge rate of the experimental group was higher than that of the control group, and the mortality of the experimental group was lower than that of the control group, and the differences were statistically significant (P＜0.05). The incidence of infection and bleeding after operation in the experimental group was lower than that in the control group, with significant difference(P＜0.05). Conclusion Preoperative intestinal decontamination can reduce the incidence of acute pancreatitis after ERCP, alleviate postoperative abdominal pain and other discomforts, improve the prognosis of patients and reduce medical costs, which is worthy of clinical application.

Key words： Preoperative intestinal decontamination Acute pancreatitis Endoscopic retrograde cholangiopancreatography Hyperamylasemia

基金资助:江西省卫生计生委科技计划项目（20197439）

引用本文:

舒宏春；练火军；诸葛群；周卫萍；郑美虹；邓辉球. 术前肠道去污预防ERCP术后急性胰腺炎的前瞻性随机对照研究[J]. 中国当代医药, 2020, 27(19): 42-45.
SHU Hong-chun；LIAN Huo-jun；ZHUGE Qun；ZHOU Wei-ping；ZHENG Mei-hong；DENG Hui-qiu. Prospective randomized controlled study of preoperative intestinal decontamination in the prevention of acute pancreatitis after ERCP. 中国当代医药, 2020, 27(19): 42-45.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I19/42

[1]	唐敏，陶莉，方倩倩，等.吲哚美辛联合生长抑素或奥曲肽预防内镜下逆行胰胆管造影术后胰腺炎的回顾性研究[J].安徽医药，2017，21（6）：1091-1094.
[2]	马微微，王彬，李影.内镜下逆行胰胆管造影术后并发症的原因分析与护理对策[J].中国医刊，2017，52（1）：82-84.
[3]	陈文华，林军，王剑屏，等.ERCP 术后胰腺炎的危险因素及预防措施[J].国际消化病杂志，2018，38（2）：79-83.
[4]	王艳静，许丙辉，台剑熊，等.生长抑素联合硫酸镁治疗ERCP 术后急性胰腺炎临床效果及安全性分析[J].解放军医药杂志，2017，29（6）：74-77.
[5]	朱国福，祝志太，祝三秀.早期肠道去污联合肠内营养治疗重症急性胰腺炎的临床疗效[J].实用临床医学，2015，16（4）：34.
[6]	何柳，张铭光.治疗性ERCP 术后发生急性胰腺炎的危险因素分析[J].河北医学，2018，24（1）：115-118.
[7]	陈孝平，汪建平，赵继宗.外科学[M].北京：人民卫生出版社，2018.
[8]	卢俊红，杨倩，赵凤群，等.ERCP 术后发生急性胰腺炎的危险因素分析[J].中国医学前沿杂志（电子版），2018，10（3）：111-114.
[9]	袁剑波.生长抑素联合奥美拉唑防治胆总管结石患者ERCP 术后急性胰腺炎和高淀粉酶血症的疗效[J].中国医药科学，2017，7（19）：218-220.
[10]	周世文，刘斌，石向阳，等.吲哚美辛对ERCP 术后高淀粉酶血症及胰腺炎的预防作用[J].肝胆外科杂志，2017，25（2）：129-133.
[11]	刘雨晴，卢启明.血清C 反应蛋白、胰蛋白酶原-2、血小板活化因子在ERCP 术后急性胰腺炎早期诊断中的临床意义[J].医学临床研究，2017，34（2）：276-278.
[12]	刘鹏飞，冯义朝，薛顺和，等.双氯芬酸钠和鼻胆管引流预防内镜逆行性胰胆管造影术后胰腺炎及高淀粉酶血症的效果[J].中国临床保健杂志，2017，20（20）：707-709.
[13]	中华医学会消化病学分会胰腺疾病学组，中华胰腺病杂志编辑委员会，中华消化杂志编辑委员会.中国急性胰腺炎诊治指南（2019年·沈阳）[J].中华消化杂志，2019，39（11）：721-730.
[14]	周丽雅，李柯.高淀粉酶血症[J].中国医师进修杂志，2004，27（17）：1-3.
[15]	刘璐，邓涛，万新月，等.胰管支架预防高危ERCP 术后胰腺炎的临床分析[J].胃肠病学和肝病学杂志，2013，22（11）：1087-1090.
[16]	杨新弘.吲哚美辛栓术前术后塞肛预防ERCP 术后患者发生急性胰腺炎临床效果观察[J].内科，2017，12（3）：107-109.
[17]	《中国全科医学》编辑部.美国消化内镜学会指南：ERCP在胰腺疾病诊治中的作用[J].中国全科医学，2005，8（22）：1865.
[18]	李文桃，杨洪吉.内镜下逆行胰胆管造影术后胰腺炎预防的研究进展[J].实用医院临床杂志，2017，14（2）：140-143.
[19]	蒋玭露，金翔，陈锐.胰管支架预防困椎胆管插管ERCP术后急性胰腺炎的可行性及安全性探究[J].中国现代医生，2018，56（30）：13-16.
[20]	戴旭.治疗性ERCP 术后发生急性胰腺炎的危险因素分析[D].南宁：广西医科大学，2017.
[21]	王翀，李国华，叶鹏，等.生大黄预防ERCP 术后胰腺炎的疗效观察[J].中国普通外科杂志，2017，26（3）：386-389.