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血必净注射液联合奥曲肽、乌司他丁治疗急性重症胰腺炎的临床观察
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| 篇名： | 血必净注射液联合奥曲肽、乌司他丁治疗急性重症胰腺炎的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察血必净注射液联合奥曲肽、乌司他丁治疗急性重症胰腺炎的临床疗效。方法：收集2012年1月－2016年1月我院急诊科收治的急性重症胰腺炎患者150例，按治疗方案不同分为对照组、药物对照组和观察组，各50例。3组患者均给予禁食、胃肠减压、抗感染、血液净化等常规治疗，对照组患者在常规治疗的基础上静脉注射醋酸奥曲肽注射液0.1 mg，tid；药物对照组在对照组基础上加用注射用乌司他丁注射液10万单加入10％葡萄糖注射液250 mL中，ivgtt，bid；观察组患者在药物对照组基础上加用血必净注射液100 mL加入10％葡萄糖注射液100 mL中，ivgtt，bid。3组患者均治疗10 d。观察3组患者的总有效率及胃肠减压时间、腹痛缓解时间、住院时间等临床指标，并比较3组患者治疗前后血清相关指标[血清淀粉酶（AMY）、白细胞（WBC）、白细胞介素6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）]及治疗过程中的并发症发生情况等。结果：观察组患者的总有效率为90.0％，显著高于药物对照组的72.0％和对照组的52.0％，差异均有统计学意义（P＜0.05）。观察组患者胃肠减压时间、腹痛缓解时间、住院时间显著短于药物对照组和对照组，差异均有统计学意义（P＜0.05）。治疗前，3组患者血清AMY、WBC、IL-6、CRP、TNF-α水平比较，差异无统计学意义（P＞0.05）；治疗后，3组患者上述血清相关指标均显著降低，且观察组显著低于药物对照组和对照组，差异均有统计学意义（P＜0.05）。观察组患者急性呼吸窘迫综合征、休克、急性肾功能衰竭发生率显著低于药物对照组和对照组，差异有统计学意义（P＜0.05）；3组患者败血症、腹腔脓肿、多器官功能障碍综合征发生率比较，差异均无统计学意义（P＞0.05）。结论：血必净注射液联合奥曲肽、乌司他丁治疗急性重症胰腺炎疗效显著，能有效控制急性重症胰腺炎患者炎症进展，改善临床症状，促进病情恢复，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of Xuebijing injection combined with octreotide and ulinastatin in the treatment of acute severe pancreatitis. METHODS： A total of 150 patients with acute severe pancreatitis admitted to emergency department of our hospital during Jan. 2012-Jan. 2016 were divided into control group， drug control group and observation group according to therapy method， with 50 cases in each group. All patients were treated with fasting， gastrointestinal decompression time， antibiotics， blood purification and other conventional treatment. Control group additionally received Cctreotide acetate injection 0.1 mg intravenously， tid， on the basis of conventional treatment. Drug control group additionally received Ulinastatin for injection 100 000 U added into 10％ Glucose injection 250 mL， ivgtt， bid， on the basis of control group. Observation group additionally received Xuebijing injection 100 mL added into 10％ Glucose injection 100 mL， ivgtt， bid， on the basis of drug control group. Three groups were treated for 10 days. The clinical indexes as fotal response rates， gastrointestinal decompression time， abdominal pain relief time， length of stay were observed in 3 groups. Related serum indexes （AMY， WBC， IL-6， CRP， TNF-α） before and after treatment and the occurrence of compliance during treatment were compared among 3 groups. RESULTS： The total response rate of observation group was 90.0％， which was significantly higher than 72.0％ of drug control group and 52.0％ of control group， with statistical significance （P＜0.05）. The gastrointestinal decompression time， abdominal pain relief time and length of stay in observation group were significantly shorter than drug control group and control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in the serum levels of AMY， WBC， IL-6， CRP or TNF-α among 3 groups （P＞0.05）. After treatment， above serum indexes of 3 groups were decreased significantly， and observation group was significantly lower than the drug control group and control group， with statistical significance （P＜0.05）. The incidence of ARDS， shock and acute renal failure in observation group were significantly lower than drug control group and control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of sepsis， abdominal abscess or MODS among 3 groups （P＞0.05）. CONCLUSIONS： Xuebijing injection combined with octreotide and ulinastatin show significant therapeutic efficacy for acute severe pancreatitis， can effectively control inflammation progress， improve clinical symptoms and promote disease recovery with good safety. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 陈凯立，张汉洪，林龙，霍娟勇，邢金莉 |
| AUTHORS： | CHEN Kaili，ZHANG Hanhong，LIN Long，HUO Juanyong，XING Jinli |
| 关键字： | 奥曲肽；乌司他丁；血必净注射液；急性重症胰腺炎 |
| KEYWORDS： | Octreotide； Ulinastatin； Xuebijing injection； Acute severe pancreatitis |
| 阅读数： | 316 次 |
| 本月下载数： | 1 次 |
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