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目的:观察不同时间给予吲哚美辛肛栓对ERCP术后血淀粉酶升高、胰腺炎发生及疼痛程度的影响，探讨最佳给药时间。方法:选取2018年5月至2019年5月间上海交通大学医学院附属新华医院普外科收治的240例拟行ERCP治疗胆管疾病患者，按数字表法随机分为6组，每组40例，分别于ERCP术前120、60、30 min及术后30、60、120 min给予直肠内吲哚美辛100 mg纳肛。比较各组间ERCP术后高淀粉酶血症、ERCP术后胰腺炎(PEP)发生率及术后疼痛程度的差异。结果:术前给药组患者的术后24 h血淀粉酶升高倍数、高淀粉酶血症发生率、PEP发生率及术后3、24 h的疼痛评分均显著低于术后给药组[(4.2±1.9)倍比(4.7±2.1)倍，36.7%比46.7%，19.2%比24.2%，(5.9±2.1)分比(6.4±1.4)分，(3.8±1.7)分比(4.3±1.4)分，n P值均<0.05]，其中术前30 min给药组患者术后血淀粉酶升高倍数最小[(2.5±1.2)倍]，术后高淀粉酶血症及PEP发生率最低[27.5%(11/40)，12.5%(5/40)]，术后疼痛评分最低[(3.0±1.2)分]。n 结论:吲哚美辛肛栓可降低ERCP术后高淀粉酶血症及PEP发生率、减轻患者术后疼痛的程度，术前30 min给药可获得最佳的预防效果。“,”Objective:To observe the effects of different indomethacin anal suppository administration time on increased serum amylase, pancreatitis onset and the degree of pain after ERCP, and explore the optimal administration time.Methods:A total of 240 patients with cholangiopathy who were admitted and planned to be treated by ERCP in Department of General Surgery of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2018 to May 2019 were randomly divided into 6 groups using random number method with 40 patients in each group, who were given 100 mg intrarectal indomethacin at 120 min, 60 min, 30 min before ERCP and 30 min, 60 min, 120 min after ERCP. The incidence of post-ERCP hyperamylasemia, post-ERCP pancreatitis (PEP) and the degree of postoperative pain were compared among different groups.Results:The increased times of blood amylase level and the incidence of hyperamylasemia and PEP at 24 hour, and postoperative 3 h and 24 h pain scores in preoperative medication group were significantly lower than those in postoperative medication group [(4.2±1.9)n vs(4.7±2.1), 36.7% n vs 46.7%, 19.2% n vs 24.2%, (5.9±2.1) n vs(6.4±1.4) and(3.8±1.7) n vs (4.3±1.4)score, all n P<0.05), and the amylase increased times (2.5±1.2), the incidence of hyperamylasemia and PEP[(27.5%(11/40)n vs 12.5%(5/40), and postoperative pain score (3.0±1.2) were the least in preoperative 30 min medication group.n Conclusions:Indomethacin anal suppository can reduce the incidence of postoperative hyperamylasemia and PEP and mitigate the pain degree after ERCP, and indomethacin given 30 minutes before ERCP may obtain the best preventive effect.