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目的探讨乌司他丁、奥曲肽预防治疗性ERCP术后高淀粉酶血症和胰腺炎的临床疗效。方法将拟行治疗性ERCP患者随机分为3组。对照组ERCP术后仅采用禁食、抗炎、补液、营养支持等常规治疗,术后1h给予NS500ml滴注2h滴完;奥曲肽组(治疗1组)在对照组用药基础上,ERCP术前1h给予奥曲肽0.1mg皮下注射1次,术后1h给予奥曲肽0.1mg+NS500ml持续匀滴2h,静脉滴注停止后6h、12h再分别给予奥曲肽0.1mg皮下注射各1次;乌司他丁联合奥曲肽组(治疗2组)在对照组用药基础上,ERCP术前1h给予奥曲肽0.1mg皮下注射1次,术后1h给予乌司他丁10wu+NS500ml均匀滴注2h滴完,静脉滴注停止后6h、12h再分别给予奥曲肽0.1mg皮下注射各1次。结果奥曲肽组、联合组与对照组比较,在高淀粉酶血症及ERCP术后胰腺炎发生率差异均有统计学意义(P<0.05),奥曲肽组与联合组比较,差异无统计学意义(P>0.05)。结论乌司他丁联合奥曲肽及单用奥曲肽对治疗性ERCP术后高淀粉酶血症、胰腺炎均有预防作用。
Objective To investigate the clinical efficacy of ulinastatin and octreotide in prevention and treatment of hyper amylase and pancreatitis after ERCP. Methods The patients scheduled for treatment of ERCP were randomly divided into three groups. The patients in the control group were treated with conventional therapy such as fasting, anti-inflammatory, fluid replacement and nutritional support only after 2 hours of NS500ml instillation at 1h after operation. On the basis of the control group, octreotide group (treatment 1) Given octreotide 0.1mg subcutaneous injection of 1 octreotide 0.1mg + NS500ml 1h postoperative sustained sustained drip 2h, intravenous drip stopped 6h, 12h then given octreotide 0.1mg subcutaneous injection of 1 each; ulinastatin combined with octreotide group (Treatment group 2) on the basis of the control group, 0.1 mg of octreotide was given subcutaneously once a day prior to ERCP, 1 hour after ulinastatin 10 wk + NS 500 ml was dripped for 2 hours, and 6 hours after the intravenous drip stopped. 12h then given octreotide 0.1mg subcutaneous injection of 1 each. Results The octreotide group, the combination group and the control group were significantly different in the incidence of hypermylasemia and post-ERCP pancreatitis (P <0.05). There was no significant difference between the octreotide group and the combined group P> 0.05). Conclusions Ulinastatin combined with octreotide and octreotide may have preventive effects on hypermylase and pancreatitis after ERCP.