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  • 韦璐,李平,王长青.胰管支架预防高危患者逆行胰胆管造影术后胰腺炎[J].第二军医大学学报,2015,36(12):1319-1323    [点击复制]
  • WEI Lu,LI Ping,WANG Chang-qing.Pancreatic duct stent preventing post endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients[J].Acad J Sec Mil Med Univ,2015,36(12):1319-1323   [点击复制]
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胰管支架预防高危患者逆行胰胆管造影术后胰腺炎
韦璐*,李平,王长青
0
(南京医科大学第二附属医院消化科, 南京 210011
*通信作者)
摘要:
目的 探讨胰管支架置入在预防高危患者经内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)及高淀粉酶血症中的作用。 方法 回顾性分析2013年1月至2014年12月间我院行ERCP治疗的160例PEP高危患者的临床资料。依据是否置入胰管支架,将其分为胰管支架组82例(放置支架)和对照组78例(未放置支架)。观察患者术后腹痛情况,监测术后3、24 h血清淀粉酶水平, 比较两组术后PEP、高淀粉酶血症的发生率。 结果 胰管支架组术后3 h和术后24 h血清淀粉酶水平分别为(184.89±257.33)U/L和(268.07±344.73)U/L,均低于对照组[分别为(305.35±371.81)U/L和(465.86±639.94)U/L],差异有统计学意义( P <0.05)。胰管支架组PEP、高淀粉酶血症发生率[2.4%(2/82)、17.1%(14/82)]低于对照组[11.5%(9/78)、30.8%(24/78)],差异有统计学意义( P <0.05)。胰管支架组术后腹痛发生率、腹痛评分[19.5% (16/82)、(1.24±0.58)]均低于对照组[43.6%(34/78)、(1.68±0.97)],差异有统计学意义( P =0.001)。 结论 胰管支架置入可有效预防高危患者PEP及高淀粉酶血症的发生。
关键词:  胰管支架  内镜逆行胰胆管造影术  胰腺炎  高淀粉酶血症  高危患者
DOI:10.3724/SP.J.1008.2015.01319
投稿时间:2015-07-29修订日期:2015-09-06
基金项目:
Pancreatic duct stent preventing post endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients
WEI Lu*,LI Ping,WANG Chang-qing
(Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu, China
*Corresponding author.)
Abstract:
Objective To evaluate the preventive effect of pancreatic duct stent against post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and hyperamylasemia in high-risk patients. Methods A total of 160 patients with high-risk PEP underwent ERCP therapy between Jan. 2013 and Dec. 2014 and were retrospectively analyzed. The patients were divided into pancreatic duct stent group (n=82) and control group (n=78) according to whether receiving pancreatic duct stent or not. Abdominal pain was evaluated after ERCP. The levels of serum amylase were detected at 3 h and 24 h after ERCP. The incidences of PEP and hyperamylasemia were compared between the two groups. Results The serum amylase levels at 3 h and 24 h after ERCP in pancreatic duct stent group were significantly lower than those in control group ([184.89±257.33] U/L vs [305.35±371.81] U/L, P <0.05; [268.07±344.73] U/L vs [465.86±639.94] U/L, P <0.05). The incidences of PEP and hyperamylasemia in pancreatic duct stent group were also significantly lower than those in control group (2.4%[2/82] vs 11.5%[9/78], P <0.05;17.1%[14/82] vs 30.8%[24/78], P <0.05). The incidence of abdominal pain and abdominal pain score were (19.5%[16/82], [1.24±0.58]) in pancreatic duct stent group, which were significantly lower than those in control group (43.6% [34/78], [1.68±0.97]) ( P =0.001). Conclusion Pancreatic duct stent can effectively prevent PEP and hyperamylasemia in high-risk patients following ERCP.
Key words:  pancreatic duct stent  endoscopic retrograde cholangiopancreatography  pancreatitis  hyperamylasemia  high-risk patients