Effect Of Early Intervention With Magnesium Sulfate In Acute Biliary Pancreatitis

Objective: Recently, much research confirmd that Oddi sphincter plays animportant role in keeping regular function of gallbladder and pancreas, and Oddidysfunction relates to many diseases of gallbladder and pancreas. Sphincter of Oddidysfunction has become a clinical common disease. The pathogenesis of acute biliarypancreatitis is that the gallstone incarcerates in the common channel ofcholedochopancreatic duct, which causes the reflux of bile acid into pancreatic duct, andresults in pancreatitis, in the meantime, Oddi sphincter spasm occurs. Oddi sphincterspasm is a type of sphincter of Oddi dyskinesia category and can cause acute biliarypancreatitis. Studies have shown that magnesium sulfate can alleviate symptoms ofsphincter of Oddi spasm.，help the gallstone to discharge, and then alleviate acutebiliary pancreatitis. Therefore, on the base of researching on patients with acute biliarypancreatitis in clinic, we are to observe the effective of magnesium sulfate on acutebiliary pancreatitis in the early stage.Method: By adopting retrospective study,67cases of early application ofmagnesium sulfate were chosen as the observation team while54patients who wereuntreated with magnesium sulfate as a control group. The patients with underlyingdiseases、biliary-enteric anastomosis and malignancy are eliminated. Both of theteams are treated as standard non-surgical. Magnesium sulfate50~60ml (tube injection)of treatment is given to the observation team when hospitalizing, the same dose is givenin every8hours. After24hours, observation will be performed on the rate of AMYdropping,pain relief, temperature dropping, leukocyte reducing, emergency surgeryhappening (PTCD and traditional and ERCP+ENBD+ESTand Laparoscopic operation)as well as the status of defecation. Much more attention should be paid to the effects onthe severe patients with magnesium sulfate treatment, comparing the population of painrelief as well as the emergency surgery statistics with the control team who is conducting the same activities at the same time. In addition, the pain relief rate for thepatients who are hospitalized in different timing needs to be considered as well, whichincludes the time slots between0~12hours、12~24hours and after24hours.Result: In the control team after24hours, the rate of AMY dropping,，painrelief, temperature dropping, leukocyte reducing and the status of defecation issignificantly higher than the control team；while the happening rate of emergencysurgery (PTCD and traditional and ERCP+ENBD+ESTand Laparoscopic operation)islower than the control team. The result above is being of significance in statisticalarea (P<0.01). However, there is slightly difference for the severe ABP patientspertaining to the rate of emergency surgery happening and pain relief (P>0.05). Theshorter the magnesium sulfate is injected, the faster the pain relief will be effected.Conclusion: Choosing magnesium sulfates to intervene early on mild ABP canalleviate the symptoms, reduce the AMY level and happening rate of emergencysurgery and also promote the bowel movements. Hence, we believe magnesium sulfatemay alleviate the Oddi sphincter spasm, remove obstruction of the lower bile duct andcontrol the development of ABP. But it seems not significant impact to severe ABP.The shorter the magnesium sulfate is injected, the faster the pain relief will be effected.