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目的 评价西咪替丁对经内镜逆行胰胆管造影 (ERCP)术后高淀粉酶血症及急性胰腺炎的预防作用。方法 将 414例患者随机分为A、B、C三组 ,A组 (15 8例 )分别于术前一日、当日及术后一日给予西咪替丁 (80 0mg/d ,静脉滴注 ) ,B组 (147例 )分别于术前 30min及术后 4h内给予生长抑素类似物奥曲肽 0 1mg皮下注射 ,C组 (10 9例 )给予安慰剂。术前、术后 3h及 2 4h检测血清淀粉酶 (正常参考值 10～ 12 0U/L)及肝、肾功能。结果 A组有 5例 (3 16 % )、B组 4例 (2 72 % )和C组 9例 (8 30 % )发生急性胰腺炎 (A组与C组比较 ,P <0 0 5 ;B组与C组比较 ,P <0 0 5 ;A组与B组比较 ,P >0 0 5 )。A组有 39例 (2 4 70 % )、B组 37例 (2 5 17% )和C组 5 8例 (5 3 2 1% )发生高淀粉酶血症 (A组与C组比较 ,P <0 0 1;B组与C组比较 ,P <0 0 1;A组与B组比较 ,P >0 0 5 )。结论 西咪替丁与奥曲肽一样能有效地预防ERCP术后高淀粉酶血症及急性胰腺炎的发生
Objective To evaluate the preventive effect of cimetidine on hypermylase and acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Methods 414 patients were randomly divided into A, B, C three groups, A group (15 8 cases) were given on the first day, the day and the day after the operation cimetidine (80 0mg / d, intravenous drip ), Group B (147 cases) were given subcutaneous injection of 0.1 mg of octreotide, which is a somatostatin analogue, 30 minutes before operation and 4 hours after operation. Group C (109 cases) received placebo. Serum amylase (normal reference value 10 ~ 12 0U / L) and liver and kidney function were detected before operation, 3h and 24h after operation. Results Acute pancreatitis occurred in 5 patients (32%) in group A, in 4 patients (72%) in group B and in 9 patients (8 30%) in group C (P <0 05; B Group C compared with C, P <0 05; A group and B group, P> 0 0 5). There were 39 cases (24.7%) in group A, 37 cases (25.17%) in group B and 58 (53.21%) in group C hyperpyrexia (group A and group C, P <0 0 1; B group compared with C group, P <0 0 1; A group and B group, P> 0 0 5). Conclusion Cimetidine and octreotide can effectively prevent the occurrence of hyper amylase and acute pancreatitis after ERCP