Abstract: Objective: To investigate the preventive effects of rectal administration of indomethacin on pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with choledocholithiasis. Methods: 70 elderly patients with choledocholithiasis undergoing ERCP were randomly divided into indomethacin group (35 cases) and placebo group (35 cases). The patients in indomethacin group were given indomethacin through rectum 30 minutes before ERCP, the patients were given placebo through rectum. The serum amylase level of patients before ERCP, 3h and 24h after ERCP were detected; and to determine whether patients with pancreatitis and hyperamylasemia. Results: The serum amylase level of patients in indomethacin group 3h and 24h after ERCP were obviously lower than placebo group (P<0.05). The incidence rate of pancreatitis and hyperamylasemia after ERCP of patients in indomethacin group were respectively 5.71% (2/35) and 17.14% (9/35), which were all obviously lower than placebo group (P<0.05). Conclusions: Rectal administration of indomethacin before ERCP can remarkably reduce the incidence of pancreatitis and hyperamylasemia, so it is worth of clinical promotion.

Key words: Indomethacin, Endoscopic retrograde cholangiopancreatography (ERCP), Pancreatitis, Hyperamylasemia

摘要： 目的: 探讨通过直肠给药的方式应用吲哚美辛预防老年胆总管结石内镜逆行胰胆管造影术(ERCP)术后胰腺炎和高淀粉酶血症的临床效果。方法: 70例需行ERCP的老年胆总管结石患者随机分为吲哚美辛组和安慰剂组,每组35例。吲哚美辛组患者ERCP术前30min直肠内给予吲哚美辛栓剂,安慰剂组患者ERCP术前30min直肠内给予安慰剂栓剂。分别于术前,术后3h、术后24h检测患者血清淀粉酶,并判定患者是否出现胰腺炎和高淀粉酶血症。结果: 吲哚美辛组患者术后3h、24h的血清淀粉酶水平均明显低于安慰剂组（P<0.05）。吲哚美辛组患者术后胰腺炎、高淀粉酶血症的发生率分别为5.71%（2/35）和17.14%（9/35）,均明显低于安慰剂组（P<0.05）。结论: ERCP术前直肠应用吲哚美辛能够显著降低老年患者急性胰腺炎和高淀粉酶血症的发生率,值得临床推广。

关键词: 吲哚美辛, 内镜逆行胰胆管造影术(ERCP), 胰腺炎, 高淀粉酶血症