| 刘蓉安,王一平,吴娅秋,徐 熙,刘培曦.头孢他啶对预防内镜逆行胰胆管造影术后发生胰腺炎的疗效研究[J].,2017,17(8):1498-1501 |
| 头孢他啶对预防内镜逆行胰胆管造影术后发生胰腺炎的疗效研究 |
| The Efficacy of Lamivudine in Prevention of Acute Pancreatitis after Endoscopic Retrograde Cholangiopancreatography |
| 投稿时间：2016-10-20 修订日期：2016-11-13 |
| DOI：10.13241/j.cnki.pmb.2017.08.024 |
| 中文关键词: 胰腺炎 头孢他啶 内镜逆行胰胆管造影 |
| 英文关键词: Pancreatitis Lamivudine Endoscopic retrograde cholangiopancreatography |
| 基金项目:四川省卫生厅科研基金项目（130236） |
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| 中文摘要: |
| 摘要 目的：评估头孢他啶预防内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）的疗效。方法：选取456例待行ERCP的患者，将患者随机分为头孢他啶组与双氯芬酸钠组，术前，双氯芬酸组患者接受100mg双氯芬酸钠直肠给药和安慰剂静脉滴注，头孢他啶组患者给予2g头孢他啶静脉注射和安慰剂直肠给药。比较两组患者PEP的发病率和疾病程度，评估PEP发生的危险因素，评估血清和淀粉酶水平、腹痛VAS评分对PEP的早期预测价值。结果：两组患者的PEP发生率与疾病程度比较差异无统计学意义（P＞0.05）；年龄＞45岁对于PEP的发生有显著的预测作用（RR=0.17，95%CI：0.04-0.75，P＜0.05）；腹痛VAS评分、血清与尿淀粉酶水平的ROC曲线下表面积分别为0.996（95%CI：0.992-0.999，P<0.0001）、0.882（95% CI：0.851-0.938，P<0.0001）和0.897（95% CI：0.862-0.946，P<0.0001）。结论：对于非甾体类抗炎药禁用且待行ERCP的患者，头孢他啶可作为预防PEP的替代品。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the efficacy of lamivudine in prevention of acute pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP). Methods: 456 patients treated for ERCP were randomly divided into the ceftazidime group and the diclofenac sodium group. Before surgery, patients in diclofenac group received 100mg rectal administration of diclofenac sodium and intravenous placebo, and those in ceftazidime group were treated with 2 g ceftazidime intravenous injection and rectal administration of placebo. The incidence and degree of PEP were compared between the two groups. The risk factors related to the occurrence of PEP were evaluated, and the early predictive value for PEP of abdominal pain VAS score, serum and amylase level were assessed. Results: The PEP incidence and severity had no statistical difference between the two groups (P＞0.05). Age＞45 years was a significant predictor for the occurrence of PEP (RR=0.17, 95%CI: 0.04-0.75, P < 0.05). and, the surface area under ROC curve was respectively 0.996 (95%CI: 0.992 - 0.999, P<0.0001), 0.882 (95% CI: 0.851-0.938, P<0.0001) and 0.897 (95% CI: 0.862-0.946, P<0.0001) for stomachache VAS score, serum level and urine amylase level. Conclusion: For the patients who are waiting for ERCP surgery but forbidden to take non-steroidal antiinflammatory drugs (NSAIDs), lamivudine could be a good substitute for the prevention of PEP. |
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