抗炎症反应药物对重症急性胰腺炎的影响

发布时间：2018-05-03 12:18

本文选题：重症急性胰腺炎 + 血必净　；参考：《中国老年学杂志》2015年14期

【摘要】：目的探讨抗炎性反应药物在临床上治疗重症急性胰腺炎(SAP)患者的具体作用。方法对该院重症医学科2013年4月至2014年4月收治的SAP患者,均进行禁饮禁食、胃肠减压、容量复苏,行48 h连续血液净化,生长抑素、加贝酯抑制胰腺分泌,质子泵抑制剂(PPi)抑酸,预防感染、控制血糖、纠正内环境紊乱,中药灌肠等标准治疗,其中28例加用乌司他丁联合血必净治疗(治疗组),12例加用等量生理盐水进行对照(对照组),比较在治疗48 h后的心率、呼吸频率、氧合指数、乳酸、腹内压、急性生理与慢性健康状况评分(APACHE)Ⅱ的变化情况以及对ICU住院时间和死亡率的影响。结果治疗组在呼吸频率、氧合指数、腹内压方面改善较对照组更为明显(P0.05),两组在ICU住院时间和死亡率方面无明显差异(P0.05)。结论乌司他丁联合血必净治疗能在早期改善重症胰腺炎急性呼吸窘迫综合征的症状,降低腹腔内压力。
[Abstract]:Objective to investigate the effect of anti-inflammatory drugs in the treatment of severe acute pancreatitis (SAP) patients. Methods from April 2013 to April 2014, all patients with SAP were treated with fasting, gastrointestinal decompression, volume resuscitation, 48 h continuous blood purification, somatostatin and Gabexin inhibiting pancreatic secretion. Proton pump inhibitor (PPiA) inhibits acid, prevents infection, controls blood sugar, corrects internal environmental disorders, and so on standard treatment with Chinese medicine enema. Among them, 28 cases were treated with ulinastatin combined with Xuebijing (treatment group, 12 cases were treated with the same amount of normal saline as control group) (control group, the heart rate, respiratory frequency, oxygenation index, lactic acid, intra-abdominal pressure were compared after 48 h treatment. Changes of acute physiological and chronic health status score (Apache II) and their effects on hospitalization time and mortality of ICU. Results the improvement of respiratory frequency, oxygenation index and intra-abdominal pressure in the treatment group was more obvious than that in the control group (P 0.05). There was no significant difference in ICU hospitalization time and mortality between the two groups. Conclusion Ulinastatin combined with Xuebijing can improve the symptoms of severe acute respiratory distress syndrome and reduce abdominal pressure in early stage.
【作者单位】：重庆医科大学附属第二医院中心ICU;
【分类号】：R576

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