摘要
目的 探讨生长抑素联合内镜下鼻胆管引流术(ENBD)在胆总管结石行ERCP术中的应用价值.方法 选取2021年1月至2022年12月在安徽医科大学附属安庆第一人民医院龙山院区肝胆外科行ERCP治疗的150例胆总管结石患者为研究对象,按照治疗方式不同分成3组:生长抑素组50例、吲哚美辛组50例、生长抑素联合ENBD组50例.比较3组患者ERCP术后胰腺炎(PEP)及高淀粉酶血症的发生率,并发症发生率,术后3h、24h、48h谷丙转氨酶、谷草转氨酶、血淀粉酶、白细胞变化情况,以及术后术后视觉模拟评分法(VAS)疼痛评分、术后住院时间、术后费用.结果 生长抑素联合ENBD组术后3h、24h、48h高淀粉酶血症、PEP、并发症发生率以及住院时间低于生长抑素组和吲哚美辛组,差异有统计学意义(P＜0.05).3组患者术后3h VAS疼痛评分比较,差异无统计学差异(P＞0.05),术后24h、48h VAS疼痛评分生长抑素联合ENBD组低于生长抑素组和吲哚美辛组,差异有统计学意义(P＜0.05).生长抑素联合ENBD组术后费用高于生长抑素组和吲哚美辛组,差异有统计学意义(P＜0.05).术后3h、24 h、48h白细胞数值、谷草转氨酶、谷丙转氨酶相比较,3组间差异无统计学意义(P＞0.05).结论 相较于生吲哚美辛以及生长抑素单药,生长抑素联合ENBD能够有效降低胆总管结石行ERCP术后胰腺炎及高淀粉酶血症的发生率,并能减少患者住院时间,患者能够从中获益.
Abstract
Objective To explore the application value of somatostatin combined with endoscopic nasobiliary drainage(EN-BD)in ERCP for choledocholithiasis.Methods 150 patients with choledocholithiasis underwent ERCP surgery at the Hepatobiliary Department of Anqing First People's Hospital of Anhui Medical University from January 2021 to December 2022 were selected as the study subjects.They were divided into three groups according to different treatment methods:50 patients in the somatostatin group,50 patients in the indomethacin group,and 50 patients in the somatostatin combined with ENBD group.Compared the incidence of pancre-atitis(PEP)and hyperamylasemia after ERCP among three groups of patients,the incidence of complications,changes in alanine ami-notransferase,aspartate aminotransferase,blood amylase,and white blood cells at 3,24,and 48 hours postoperatively,as well as postoperative pain score(VAS),postoperative hospital stay,and postoperative expenses.Results The incidence of hyperamylasemia,PEP at 3 hours,24 hours,and 48 hours postoperatively,complications,and hospital stay in the somatostatin combined with ENBD group were lower than those in the somatostatin group and the indomethacin group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in VAS between the three groups of patients at 3 hours after surgery(P＞0.05).The VAS levels in the combination of somatostatin and ENBD group were lower than those in the somatostatin group and the in-domethacin group at 24 and 48 hours after surgery,and the difference was statistically significant(P＜0.05).The postoperative cost of the combination of somatostatin and ENBD group was higher than that of the somatostatin group and indomethacin group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in white blood cell count,aspartate aminotransferase,and alanine aminotransferase among the three groups at 3,24,and 48 hours after surgery(P＞0.05).Conclusion Compared to indomethacin and somatostatin monotherapy,somatostatin combined with ENBD can effectively reduce the incidence of pancreatitis and hyperamylasemia after ERCP for choledocholithiasis,and reduce the length of hospital stay for patients,which can benefit them.
维普
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