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目的:探讨加贝酯、奥曲肽和奥美拉唑联合应用预防内镜下逆行胰胆管造影(ERCP)术后胰腺炎(PEP)的作用。方法:235例ERCP术后患者随机分为治疗组(125例)和对照组(110例)。治疗组ERCP术后应用加贝酯1mg.kg-1.h-1持续静滴12h,奥曲肽0.1mg皮下注射q12h×2次,奥美拉唑40mg静注q12h×3次;对照组ERCP术后静滴生理盐水500mL。ERCP术前、术后3h、12h及24h检测血清淀粉酶并观察有无PEP的临床表现。结果:治疗组和对照组ERCP术后PEP的发生率分别为3.20%和11.82%(P<0.01),高淀粉酶血症的发生率分别为18.40%和39.09%(P<0.05)。2种并发症的发生率均有明显差异。结论:加贝酯、奥曲肽和奥美拉唑联合应用可降低ERCP术后PEP和高淀粉酶血症的发生率。
Objective: To investigate the preventive effect of combined administration of Gabbesterol, Octreotide and Omeprazole on pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP). Methods: 235 patients with ERCP were randomly divided into treatment group (125 cases) and control group (110 cases). The patients in the treatment group were treated with gabexate 1 mg.kg-1.h-1 for 12 hours, octreotide 0.1 mg subcutaneously q12h × 2 times, and omeprazole 40 mg intravenously q12h × 3 times. ERCP in the control group 500mL intravenous saline. Serum amylase was detected before ERCP, 3h, 12h and 24h after operation, and the clinical manifestations of PEP were observed. Results: The incidences of PEP after ERCP in treatment group and control group were 3.20% and 11.82%, respectively (P <0.01). The incidences of hyper amylase were 18.40% and 39.09% respectively (P <0.05). The incidence of the two complications were significantly different. Conclusions: The combination of gabexate, octreotide and omeprazole can reduce the incidence of PEP and hyper amylasemia after ERCP.