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

发布时间：2018-11-28 18:02

【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 m L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 m L加入10%葡萄糖注射液100 m L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(P0.05)。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(P0.05)。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(P0.05);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(P0.05)。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(P0.05);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(P0.05)。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 the clinical effect of Xuebijing injection combined with octreotide and ulinastatin in the treatment of severe acute pancreatitis. Methods: from January 2012 to January 2016, 150 patients with severe acute pancreatitis were divided into control group, drug control group and observation group, 50 patients in each group were treated with fasting and gastrointestinal decompression. Patients in control group were treated with routine therapy such as anti-infection and blood purification. Patients in control group were treated with octreotide acetate injection 0.1 mg,tid; on the basis of routine treatment. The drug control group added ulinastatin injection 100000 for injection to 250ml of 10% glucose injection on the basis of control group. Ivgtt,bid; The patients in the observation group were treated with Xuebijing injection 100ml and 10% glucose injection 100ml on the basis of the drug control group. All the patients in the ivgtt,bid.3 group were treated for 10 days. The total effective rate, gastrointestinal decompression time, abdominal pain relief time and hospitalization time were observed in the three groups. The serum relative indexes [serum amylase (AMY), leukocyte (WBC),] were compared before and after treatment. Interleukin 6 (IL-6), C reactive protein (CRP), tumor necrosis factor 伪 (TNF- 伪) and complications during treatment. Results: the total effective rate of the patients in the observation group was 90.0, which was significantly higher than that in the drug control group (72.0%) and the control group (52.0%). The difference was statistically significant (P0.05). The time of gastrointestinal decompression, the time of relieving abdominal pain and the time of hospitalization were significantly shorter in the observation group than in the drug control group and the control group (P0.05). Before treatment, there was no significant difference in serum AMY,WBC,IL-6,CRP,TNF- 伪 levels among the three groups (P0.05). After treatment, the serum related indexes of the three groups were significantly decreased, and the observation group was significantly lower than the drug control group and the control group, the difference was statistically significant (P0.05). The incidence of acute respiratory distress syndrome, shock and acute renal failure in the observation group was significantly lower than that in the drug control group and the control group (P0.05). There was no significant difference in the incidence of septicemia, abdominal abscess and multiple organ dysfunction syndrome among the three groups (P0.05). Conclusion: Xuebijing injection combined with octreotide and ulinastatin is effective in the treatment of severe acute pancreatitis. It can effectively control the inflammatory progression of patients with severe acute pancreatitis, improve clinical symptoms and promote the recovery of the disease.
【作者单位】：海南省中医院急诊科;海南省中医院普外科;海南省中医院重症科;
【分类号】：R576

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