内科

目的评价生长抑素联合泮托拉唑预防经内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）和高淀粉酶血症的临床价值。方法将268例胆总管结石需行ERCP术治疗的患者随机分为对照组和观察组各134例。对照组患者给予禁食、补液、支持等一般治疗。观察组患者在对照组患者治疗的基础上给予生长抑素及泮托拉唑治疗：生长抑素3 mg加入0.9%生理盐水60 mL静脉微泵泵入，5 ml/h，持续24 h；泮托拉唑40 mg加入0.9%生理盐水100 mL静脉点滴，2次/d，共用48 h。比较患者ERCP术前、术后3 h、术后24 h血清淀粉酶及术后胰腺炎高淀粉酶血症的发生情况。结果术后3 h、术后24 h观察组患者血清淀粉酶均低于对照组，差异有统计学意义（P＜0.05）。对照组患者ERCP术后发生急性胰腺炎14例（10.45%），术后3 h、术后24 h出现高淀粉血症63例（47.01%）和37例（27.61%）；观察组患者ERCP术后发生急性胰腺炎2例（1.49%），术后3 h、术后24 h出现高淀粉血症29例（21.64%）和13例（9.70%）。两组比较差异有统计学意义（P＜0.01）。结论生长抑素联合泮托拉唑预防干预可明显减少ERCP术后患者胰腺炎和高淀粉酶血症的发生。

ObjectiveTo investigate the prophylactic effect of somatostatin combined with pantoprazole sodium on pancreatitis and hyperamylasemia after ERCP. Methods268 patients underwent ERCP were randomly divided into observation group and control group, with134 cases in each. The control group was received routine treatment,such as fasting, rehydration, support treatment,while the observation group was given somatostatin of 3mg dissolve in 60 mL of physiological saline after the procedure,intravenous infusion,5ml/hour, for 24 hours; and Pantoprazole of 40mg dissolve in 100mL of physiological saline, I.V., 2 times a day,for 48 hours. The levels of serum amylase were detected before and 3 and 4 hours after the procedure.The clinical manifestations of pancreatitis were observed simultaneously. ResultsThe levels of serum amylase were lower in the observation group than those in the control group 3 and 4 hours post ERCP（P＜0.05). The occurrence of acute pancreatitis patients in control group was 10.45% (14/134), significantly higher than that of the observation group;3 and 24 h post ERCP, the incidence of hyperamylasemia were 21.64% and 9.70% in the observation group, significantly lower than that in the control group(47.01% and 27.61%,P＜0.05).ConclusionSomatostatin combined with pantoprazole sodium can effectively prevent hyperamylasemsa and pancreatitis after ERCP.