Clinical Analysis Of Indomethacin Combined With Somatostatin In The Prevention Of Pancreatitis After ERCP

ObjectiveTo explore the clinical effect of indomethacin combined with somatostatin on the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).MethodsA total of 160 patients treated with ERCP in our hospital from April 2017 to April 2019.Basic treatment: At 6-8h before operation,routine fasting for solids and liquids was performed,and at 10 minutes before operation,10 mg 654-2 was injected intramuscularly,and 100 mg tramadol + 10 mg diazepam + 0.5mg chlorpromazine were injected intramuscularly.The objects of this study were divided into a control group(basic treatment + plugging of anus with placebo),single-drug indomethacin group(basic treatment + plugging of anus with100 mg indomethacin half an hour before operation)and single-drug somatostatin group(basic treatment + pumping in somatostatin at 250μg/h intraoperatively for 11h),and observation group(basic treatment + plugging of anus with 100 mg indomethacin half an hour before operation + pumping in somatostatin at 250μg/h intraoperatively for 11h),40 cases in each group.The incidence of post-ERCP pancreatitis,serum amylase level,liver functionindexes,clinical symptoms and sign scores of the four groups of patients were compared.ResultsThe difference in age,gender,disease type,common bile duct diameter,presence or absence of Oddi sphincter incision and preoperative amylase levels,preoperative clinical symptoms and signs scores among the four groups was not statistically significant,P > 0.05.The incidence of post-ERCP pancreatitis was 37.5%(15/40)in the control group,22.5%(9/40)in the single-drug indomethacin group,30.0%(12/40)in the single-drug somatostatin group,and 10.0%(4/40)in the observation group.The incidence of post-ERCP pancreatitis in the observation group was significantly lower than that of the single-drug indomethacin group and the control group,and there was a significant difference(P <0.05).Comparison of serum amylase levels in the four groups of patients at 6h,10 h,24h and 48 h after operation: At 6h after operation,the serum amylase indexes of the four groups of patients all increased significantly,and the amylase indexes of the four groups of patients at 10,24,and 48 h after operation were significantly lower than those at 6h after operation(P <0.05).The serum amylase index of the observation group at the same time point was lower than that of the single-drug indomethacin group or the single-drug somatostatin group(P <0.05),the reduction degree of the patients treated with two drugs was significantly better than that of the single-drug indomethacin and somatostatin treatment groups,and the liver function of patients would not be affected in a short time.The scores of clinical symptoms and signs of the single-drug indomethacin group,the single-drug somatostatin group and the observation group were significantly lower than those of the control group at 6,10,24 and 48 h,and the difference was statistically significant(P <0.05);the scores of clinical symptoms and signs of the observation group at 6,10,24,and 48 h were significantly lower than those of the single-drug indomethacin group or the single-drug somatostatin group,and the difference was statistically significant(P <0.05).ConclusionsThe effect of somatostatin combined with indomethacin is significantly better than that of indomethacin or somatostatin alone,and the probability of post-ERCP pancreatitis can be reduced effectively.