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目的 观察吲哚美辛和奥曲肽对内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)术后高淀粉酶血症及胰腺炎的预防作用.方法 将行ERCP手术的180 例患者随机分为吲哚美辛组、奥曲肽组及对照组,每组60 例,观察其术前、术后3 h、术后24 h血清淀粉酶水平及ERCP术后高淀粉酶血症和胰腺炎发生率.结果 3组患者ERCP术前血清淀粉酶均为正常,差异无统计学意义(P＞0.05);ERCP术后3 h血清淀粉酶水平,吲哚美辛组[(91.6±51.4)U/L]及奥曲肽组[(119.3±68.1)U/L)均低于对照组[(153.7±90.7)U/L),差异有统计学意义(P＜0.05);吲哚美辛组低于奥曲肽组,但差异无统计学意义(P＞0.05).术后24 h血清淀粉酶水平,吲哚美辛组[(93.7±58.9)U/L]低于奥曲肽组[(219.4±113.1)U/L]及对照组[(237.9±124.8)U/L],差异具有统计学意义(P＜0.05),奥曲肽组稍低于对照组,但差异无统计学意义(P＞0.05).ERCP术后吲哚美辛组高淀粉酶血症发生率(10.0%)及胰腺炎发生率(3.3%)均低于奥曲肽组(25.0%,11.7%)及对照组(28.3%,13.3%),差异具有统计学意义(P＜0.05);奥曲肽组稍低于对照组,但差异无统计学意义(P＞0.05).结论 应用吲哚美辛能有效预防ERCP术后高淀粉酶血症及胰腺炎的发生,值得临床推广和应用,奥曲肽是否能够减少其发生率,需要进一步的研究.“,”Objective To investigate the preventive effect of indomethacin and octreotide on hyperamylasemia and post-ERCP pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 180 patients received ERCP were randomly divided into 3 groups: indomethacin group (n＝60), octreotide group (n＝60) and control group (n＝60). The serum amylase levels before and 3 h, 24 h after ERCP were measured, and the incidence of hyperamylasemia and acute pancreatitis after ERCP were observed. Results Serum amylase level before ERCP of all groups was normal without statistical difference (P＞0.05), the serum amylase level of indomethacin group[(91.6±51.4) U/L] and octreotide group [(119.3±68.1) U/L] 3 h after ERCP was significantly lower than that of control group [(153.7±90.7) U/L] (P＜0.05), and the serum amylase level of indomethacin group was lower compared with that of octreotide group, whereas no statistical difference between them (P＞0.05). At 24 h after ERCP, the serum amylase level of indomethacin group [(93.7±58.9) U/L] were significantly lower than that of octreotide group [(219.4±113.1) U/L] and control group [(237.9±124.8) U/L] (P＜0.05), and the serum amylase level of octreotide group was slightly lower compared with that of control group, but no statistical difference between them. The incidence of hyperamylasemia (11.7%) and PEP (3.3%) of indomethacin group was significantly lower than that of octreotide group (25.0%, 11.7%) and control group (28.3%, 13.3%) (P＜0.05), although the incidence of hyperamylasemia and PEP of octreotide group was slightly lower than that of control group, there was no statistical difference (P＞0.05). Conclusion The administration of indomethacin before ERCP can effectively prevent the incidence of hyperamylasemia and PEP, which is worthy of spreading and clinic use. Whether octreotide could reduce the incidence of hyperamylasemia and PEP after ERCP needs further investigation.