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低渗透压造影剂的使用是否降低了内镜逆行胰胆管造影术后胰腺炎的发生率:低渗透压与高渗透压造影剂的对比研究。

Does the Use of Low Osmolality Contrast Medium Reduce the Frequency of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Comparative Study between Use of Low and High Osmolality Contrast Media.

机构信息

Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan.

Department of Gastroenterology, SUBARU Ota Memorial Hospital, Gunma, Japan.

出版信息

Digestion. 2021;102(2):283-288. doi: 10.1159/000504702. Epub 2019 Nov 26.

Abstract

INTRODUCTION

A few reports stating that differences in the various types of contrast media injected into the pancreatic duct are related to the onset of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) have been published, and it was indicated that iodixanol which is a nonionic iodide radiographic contrast medium with a dimeric (2 dimers) structure may reduce the incidence of PEP. The aim of this retrospective study is to evaluate the usefulness of iodaxanol for prevention PEP in comparison with megulamine amidototrizoate.

METHODS

Two hundred and ninety-one patients were enrolled and divided into the 2 groups according to the contrast medium used. One hundred and fifty-five patients underwent ERCP with meglumine amidotrizoate, and 136 patients underwent ERCP with iodaxanol. The primary outcome of this study was the incidence of PEP associated with the use of each contrast medium.

RESULTS

In this study, comparison of the meglumine amidotrizoate treatment and iodaxanol treatment groups showed no significant difference with respect to the incidence of PEP. In addition, there was also no difference between the groups with respect to PEP severity.

CONCLUSION

Our study suggested that iodaxanol does not necessarily contribute to the prevention of PEP in comparison with meglumine amidotrizoate.

摘要

简介

有一些报道指出,注入胰管的不同类型的对比剂之间的差异与内镜逆行胰胆管造影术(ERCP)后胰腺炎(PEP)的发生有关,并且表明碘克沙醇是一种具有二聚体(2 个二聚体)结构的非离子型碘造影剂,可能会降低 PEP 的发生率。本回顾性研究的目的是评估碘克沙醇在预防 PEP 方面与美格胺 amidotrizoate 的效用。

方法

将 291 名患者纳入研究,并根据使用的对比剂分为两组。155 名患者接受美格胺 amidotrizoate 的 ERCP,136 名患者接受碘克沙醇的 ERCP。本研究的主要结局是使用每种对比剂发生 PEP 的发生率。

结果

在这项研究中,美格胺 amidotrizoate 治疗组和碘克沙醇治疗组之间比较,在 PEP 的发生率方面没有显著差异。此外,两组之间 PEP 的严重程度也没有差异。

结论

我们的研究表明,与美格胺 amidotrizoate 相比,碘克沙醇不一定有助于预防 PEP。

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