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胰管支架置入术预防逆行胰胆管造影术后胰腺炎高危患者PEP及高淀粉酶血症研究 被引量：4

Preventive effect of pancreatic stent placement for post-ERCP pancreatitis and hyperamylasemia in high-risk patients
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摘要 [目的]研究逆行胰胆管造影(ERCP)术后放置胰管支架对胰腺炎高危患者ERCP术后胰腺炎(PEP)和高淀粉酶血症的预防作用。[方法]回顾性分析2006年3月～2012年6月在我科住院需行ERCP治疗的PEP高危患者123例的临床资料。根据术后是否放置胰管支架,将其分为胰管支架组53例(放置支架)和对照组70例(未放置支架)。以Cotton标准诊断PEP和高淀粉酶血症,比较2组患者术前、术后6h血清淀粉酶水平,评估2组患者术后PEP和高淀粉酶血症的发生率;评估ERCP术后血清淀粉酶恢复正常的时间、PEP的发生率,分析PEP发生的高危因素。[结果]所有患者术前血清淀粉酶均正常;ERCP术后6h血清淀粉酶水平:胰管支架组(357.7±198.3)U/L,低于对照组(484.7±376.9)U/L;术后PEP的发生率:胰管支架组13例(24.5%),对照组39例(55.7%);术后高淀粉酶血症的发生率:胰管支架组22例(40.2%),对照组14例(20.0%);重症胰腺炎的发生率:胰管支架组0例(00.0%),对照组6例(8.57%);术后淀粉酶恢复正常的时间:胰管支架组为2.45d;对照组为7.85d,以上指标2组比较差异均有统计学意义(均P<0.05)。[结论]ERCP术后在高危PEP人群中应用胰管支架置入术可有效降低PEP和高淀粉酶血症患者的淀粉酶水平;明显缩短术后PEP及高淀粉酶血症恢复正常的时间;明显缩短患者总住院时间。 [Objective]To investigate the preventive effect of pancreatic stent placement on p0st-ERCP pancreatitis （PEP） and hyperamylasemia. [Methods]We retrospectively analyzed the 123 patients with high-risk PEP between March 2006 and June 2012. The patients were divided into stent placement group （n = 53） and non-stent placement group （n=70）. PEP and hyperamylasemia were diagnosed according to Cotton standard. Preoperative and 6-hours-postoperative serum amylase levels were obtained. Occurrence of PEP and hyperamylasemia and prognosis were assessed. The high-risk factors influencing PEP were ana- lyzed. [Results]Serum amylase levels before ERCP of both groups were normal. The serum amylase level of stent placement 6 hours after surgery was ／ [（357.7±198.3）U/L], which was lower than that of non-stent placement group [（484.7＋376.9）U/L] （P〈0.05）. The incidence of PEP of stents placement group （24. 5%） was lower than that of control group （55.7%）（P〈0.05）. Post-ERCP hyperamylasemia incidence of stents placement （40. 2%）was higher than that of the control group （20.0%） （P〈0.05）. [Conclusion]Pancreatic stents placement after ERCP can effectively reduce the incidence of PEP and reduce amylase levels of patients with hyperamylasemia.
作者 王苏丽 周毅 谢艳 林涛 王钧 姚茹
机构地区 解放军第四五一医院消化内科
出处 《中国中西医结合消化杂志》 CAS 2013年第3期146-149,共4页 Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词 胰腺炎 逆行胰胆管造影术 胰管支架 高淀粉酶血症 pancreatitis endoscopic retrograde cholangiopancreatography pancreatic stent place-ment hyperamylasemia
分类号 R576 [医药卫生—消化系统]
  • 相关文献

参考文献14

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二级参考文献22

  • 1潘涛,王一平,杨锦林,田玲,李耀东.胰管支架置入术预防内镜逆行胰胆管造影术后胰腺炎的系统评价[J].中国循证医学杂志,2004,4(10):693-699. 被引量：12
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共引文献26

同被引文献39

  • 1潘涛,王一平,杨锦林,田玲,李耀东.胰管支架置入术预防内镜逆行胰胆管造影术后胰腺炎的系统评价[J].中国循证医学杂志,2004,4(10):693-699. 被引量：12
  • 2冯仕彦,张希洲,李仕乾,景炳文,杨兴易,陈学云.大黄对重症急性胰腺炎血小板及凝血功能的影响[J].中华急诊医学杂志,2005,14(4):340-341. 被引量：29
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引证文献4

二级引证文献11

中国中西医结合消化杂志
2013年 第3期

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