两种不同途径应用乌司他丁治疗重症急性胰腺炎的疗效观察

Therapeutic effects of urinary trypsin inhibitor on severe acute pancreatitis in two ways of infusion

目的 探讨区域动脉灌注与静脉输注乌司他丁治疗重症急性胰腺炎(SAP)疗效的差异。方法 将38例急性胰腺炎病人分为A、B两组,A组(16例)应用Seldinger法行区域动脉灌注乌司他丁;B组(22例)乌司他丁经静脉全身给药。结果 (1) A 组病人的第 3 天、第 6 天血淀粉酶(BA)、尿淀粉酶(UA)、血糖(BS)、尿素氮(BUN)、白细胞(WBC)均低于 B 组(P 分别< 0 05、<0 01),而血钙(Ca++)则高于B组(P<0 05)。(2)A组腹痛、腹胀、压痛消失的时间短于 B组(P分别<0 05、<0 01、<0 01)。(3)根据胰源性脑病,肺部感染,胸腔积液,ARDS,心肌梗死,消化道出血,假性胰腺囊肿的发生情况考察 A、B两组的并发症,A组的并发症例数少于 B组(P<0 05)。结论 区域动脉灌注乌司他丁治疗SAP较静脉注射有更好的疗效。

Objective To compare the therapeutic effects of urinary trypsin inhibitor (UTI) administered by regional arterial infusion (RAI) with that by intravenous infusion on severe acute pancreatitis (SAP). Methods Thirty eight cases of SAP were divided into 2 groups. UTI was infused by RAI according to Seldinger method in group A (n=22) and by intravenous infusion in group B (n=16). Results The values of blood amylase, urine amylase, blood sugar, blood uria nitrogen and white blood cell count were significantly lower but that of blood calcium higher in group A than in group B on the 3rd and 6th day after the treatment, respectively (P<0 05, P<0 01, P<0 05). There was a significantly shorter period of abdominal pain, abdominal distension and tenderness in group A than in group B (P<0 05, P<0 01, respectively). Markedly less patients experienced complications such as pancreatic encephalopathy, pulmonary infection, pleural effusion, ARDS, myocardial infarction, digestive tract bleeding and pancreatic pseudocyst in group A than in group B (P<0 05). Conclusions Administration of UTI by RAI is better than that by intravenous infusion in treatment of SAP.