关键词:

非甾体类抗炎药, 急性胰腺炎, 手术并发症, 高风险人群, 经内镜逆行胰胆管造 影术, 乳头括约肌切开术

Abstract:

Objective To explore the efficacy of intravenous application of selective non⁃steroidal anti⁃ inflammatory drugs（NSAIDs）for preventing post⁃ERCP pancreatitis（PEP）after endoscopic retrograde cholangio⁃ pancreatography（ERCP）combined with endoscopic sphincterotomy（EST）. Methods The clinical data on 95 patients with choledocholithiasis who had undergone ERCP plus EST from January 1，2019 to January 1，2021 were retrospectively analyzed. After surgical treatment，the study group received selective NSAIDs，while the control group was treated with conventional drugs. According to the relevant risk factors，the total population was divided into a high⁃risk population subgroup and an average risk population subgroup. They were then subdivided into study group a（n = 31），control group a（n = 27），study group b（n = 15），and control group b（n = 22）. The clinical efficacy and safety were compared between the two groups. Results The high⁃risk population：in the study group，the incidence of PEP and the duration of abdominal pain and distension decreased，the time to resum⁃ ing eating and the postoperative hospital stay were shortened，the VAS pain score decreased，the QoR⁃15 score increased，and the levels of postoperative AMS and LPS decreased（P < 0.05）. The average risk population：post⁃ operative ALT levels in the study group and the frequency of vomiting increased，the time to resuming eating was shortened（P < 0.05）. Conclusions For the high ⁃ risk population，intravenous application of selective NSAIDs can prevent the occurrence of PEP，improve prognosis and quality of rehabilitation. However，for the average risk population，NSAIDs do not markedly reduce the occurrence of PEP and do not evidently improve prognosis and quality of postoperative rehabilitation；and it is easy to cause the patients to develop digestive system symptoms and a certain degree of liver damage.

Key words:

NSAIDs, acute pancreatitis, surgical complications, high ? risk population, ERCP, EST