摘要
目的探讨乌司他丁联合治疗重症胰腺炎患者的疗效及对临床症状、血清学指标和安全性的影响.方法将2016-02/2018-01于广东省人民医院治疗的94例重症胰腺炎患者作为研究对象,随机分为实验组(46例)与参照组(48例).参照组患者给予奥曲肽治疗,实验组患者在此基础上给予乌司他丁联合治疗.持续治疗2 wk,比较两组患者临床疗效、治疗前后血清学指标、淀粉酶指标、肠黏膜功能指标水平以及并发症发生情况.结果实验组治疗总有效率为95.65%,明显高于参照组的83.33%(P <0.05).实验组患者腹部胀痛、恶心呕吐及腹膜刺激征消失时间、首次排便时间、肠鸣音恢复时间和住院时间均比参照组短,且死亡率低于参照组(均P<0.05).两组患者治疗前C反应蛋白、肿瘤坏死因子-α、白细胞介素-18、白细胞介素-6、血淀粉酶、尿淀粉酶、细胞紧密连接蛋白、二胺氧化酶和内毒素水平比较无明显差异(P>0.05);经治疗干预后,两组患者上述指标水平均有所改善,且实验组患者改善程度明显优于参照组(均P<0.05).实验组患者急性呼吸窘迫综合征、急性肾衰竭和休克的发生率均明显低于参照组(均P<0.05);两组患者的胰性脑病综合征和代谢功能失调发生率相比均无明显差异(均P>0.05).结论乌司他丁联合治疗重症胰腺炎患者具有较好的临床效果,可以提高治疗有效率、改善患者临床症状和血清学指标、积极保护患者肠黏膜功能,且并发症发生率较低,安全性良好.
AIMTo evaluate the efficacy of ulinastatin combined withoctreotide in the treatment of severe pancreatitis and theeffect on clinical symptoms, serological indicators andsafety.METHODSNinety-four patients with severe pancreatitis who weretreated at Guangdong Provincial People’s Hospital fromFebruary 2016 to January 2018 were randomly dividedinto an experimental group （46 cases） and a referencegroup （48 cases）. The reference group was treated withoctreotide alone, and the experimental group was treatedwith octreotide combined with ulinastatin. The treatmentlasted 2 wk in both groups. Clinical curative effect,serological parameters, amylase, intestinal mucosalfunction index and complications were comparedbetween the two groups.RESULTSThe total effective rate in the experimental group was95.65%, which was significantly higher than that of thereference group （83.33%; P 〈 0.05）. Time to disappearanceof abdominal pain, nausea, vomiting and peritonealirritation, time to first defecation, time to bowel soundrecovery and hospital stay in the experimental groupwere significantly shorter than those of the referencegroup （P 〈 0.05）, and the mortality rate was significantlylower than that of the reference group （P 〈 0.05）. Therewas no significant difference in serum C-reactive protein,tumor necrosis factor-α, interleukin-18, interleukin-6,blood amylase, urine amylase, occludin, diamine oxidaseor endotoxin levels between the two groups beforetreatment （P 〉 0.05）. After treatment intervention, theabove-mentioned indicators improved significantly in both groups, and the experimental group improvedsignificantly better than those of the reference group（P 〈 0.05）. The incidence of acute respiratory distresssyndrome, acute renal failure and shock in theexperimental group was significantly lower than that ofthe reference group （P 〈 0.05）. There was no significantdifference in the incidence of pancreatic encephalopathysyndrome or metabolic dysfunction between the twogroups （P 〉 0.05）.CONCLUSIONUlinastatin combined with octreotide has good clinicaleffects in severe pancreatitis patients and can improvetreatment efficiency, clinical symptoms and serologicalindicators, protect the intestinal mucosal function, andreduce the incidence of complications.
作者
杨金芬
陈盛
夏武政
Jin-Fen Yang;Sheng Chen;Heng-Wu Xia(Department of Pharmacy,Zhejiang RongjunHospital,Jiaxing 324000,Zhejiang Province,Chin;Department of General Surgery（Division Ⅲ）,Guangdong Provincial People＇s Hospital,Guangzhou510000,Guangdong Province,China)
出处
《世界华人消化杂志》
CAS
2018年第30期1778-1783,共6页
World Chinese Journal of Digestology
关键词
重症胰腺炎
乌司他丁
奥曲肽
疗效
炎性因子
Severe pancreatitis
Ulinastatin
Octreotide
Efficacy
Inflammatory factors
