經內視鏡逆行性胰管攝影後併發胰臟炎－使用離子性與非離子性顯影劑之比較

Pancreatitis after Endoscopic Retrograde Pancreatography: A Comparative Study of Ionized and Non-Ionized Contrast Agents

張文熊(Wen-Hsiung Chang) ； 熊立榕(Li-Rung Shyung) ； 施壽全(Shou-Chuan Shih) ； 林芳杰(Fung J. Lin) ； 楊裴適(Fei-Shih Yang)

《中華民國消化系醫學會雜誌》 11卷2期 (1994/06) Pp. 120-124

https://doi.org/10.6557/GJTa.199406_11(2).0001

摘要

Pancreatitis is a major cause of morbidity and mortality secondary to endoscopic retrograde pancreatography (ERP). One factor that may cause post-ERP pancreatitis is the type of contrast media utilized during the procedure. The purpose of this prospective, double-blind, randomized study was to evaluate the effects of two contrast agents of differing osmolality and ionicity, changes in serum amylase and lipase and development of clinical symptoms of acute pancreatitis. Our study of 89 patients showed that those who received Omnipaque a non-ionic, relatively iso-osmolar contrast agent, had a significantly lower serum amylase change (20.5±3.9 U/L) (the change of conray, the ionic agent, is 157.9±31.2 U/L) (p＜0.001) and lower serum lipase change (0.21±0.06 STU/ML) (the change of conray is 2.74±0.62 STU/ML) (p＜0.001). In summary, the risk of post-ERP acute pancreatitis was significantly lower for Patients who received the non-ionic contrast agent than for those who recrived the ionic agents.

關鍵字

經內視鏡逆行性胰管攝影 ； 顯影劑 ； 胰臟炎

並列摘要

Pancreatitis is a major cause of morbidity and mortality secondary to endoscopic retrograde pancreatography (ERP). One factor that may cause post-ERP pancreatitis is the type of contrast media utilized during the procedure. The purpose of this prospective, double-blind, randomized study was to evaluate the effects of two contrast agents of differing osmolality and ionicity, changes in serum amylase and lipase and development of clinical symptoms of acute pancreatitis. Our study of 89 patients showed that those who received Omnipaque a non-ionic, relatively iso-osmolar contrast agent, had a significantly lower serum amylase change (20.5±3.9 U/L) (the change of conray, the ionic agent, is 157.9±31.2 U/L) (p＜0.001) and lower serum lipase change (0.21±0.06 STU/ML) (the change of conray is 2.74±0.62 STU/ML) (p＜0.001). In summary, the risk of post-ERP acute pancreatitis was significantly lower for Patients who received the non-ionic contrast agent than for those who recrived the ionic agents.

並列關鍵字

endoscopic retrograde pancreatography ； contrast medium ； pancreatitis