【作者】 孙克文；

【导师】 沈云志；

【作者基本信息】 苏州大学 ， 消化内科， 2002， 硕士

【摘要】 目的：探讨内镜鼻胆管引流术预防治疗性ERCP术后高淀粉酶血症及胰腺炎的应用价值。方法：140例治疗性ERCP术后有高淀粉酶血症及胰腺炎可能的病人。54例高危病人术后置鼻胆管引流，与86例非引流病人进行对照研究。观察术后2hr＼24hr血清淀粉酶值、高淀粉酶血症和急性胰腺炎发生率。结果：两组病人术后2hr血清淀粉酶值分别为170.68±116.45和275.84±333.11(P＜0.05)，高淀粉酶血症分别为9.26％和26.74％(P＜0.05)，急性胰腺炎发生率分别为0与6.98％(P＜0.05)，均具有显著差异；两组病人术后24hr血清淀粉酶值分别为234.47±437.08和349.49±504.52(P＞0.05)无显著差异；胰管显影率分别为39％和34％(P＞0.05)也无显著差异。结论：内镜鼻胆管引流能保持胆胰引流通畅，防止胆汁反流入胰管，预防治疗性ERCP术后高淀粉酶血症及胰腺炎。更多还原

【Abstract】 Objective:To assess the value of endoscopic nasol biliary drainage (ENBD)to prevent post therapeutic ERCP pancreatitis and hyperamylasemia. Methods:A series of 140patients in high risk of acute pancreatitis and hyperamylasemia after therapeutic ERCP were divided into two groups. 54patients underwent ENBD after ERCP,papillosphincterotomy and basket lithotripsy. The mean amylase lever at 2hr and 24hr after therapeutic ERCP were measured. Meanwhile the occuring of acute pancreatitis and hyperamylasemia were also observed. Results:The mean amylase lever at 2hr of the drainage group was 1 70.68 + 1 1 6. 45,significantly higher than that in the controls. ( 275.84 +333.1 1,P<0. 05). Hyperamylasemia occurred in 9.26% of patients in drainage group compared with 26.74% of patients in non-drainage group .( PO.05) Acute pancreatitis was clinically established in 6.98% of patients in non-drainage group with significance ( P<0.05)when compared with the drainage group(0%). There were significant differences in the mean amylase lever at 2h and the incidence of acute pancreatitis and hyperamylasemia. The mean amylase lever at 24hr of the drainage group was 234.47 + 437. 08,no difference with that in the controls (349.49 +504.52,P>0.05).Conc1usions:ENBD can decrease the pressure within the biliary and pancreatic duct effectively and alleviate the development of pancreatitis. It is considered that ENBD is a practiseof choice for selected to prevent post therapeutic ERCP pancreatitis and hyperamylasemia.更多还原