介入下的区域性动脉灌注治疗重症急性胰腺炎

Interventional regional arterial infusion treatment for severe acute pancreatitis

目的探讨介入下区域性动脉灌注治疗重症急性胰腺炎(SAP)的价值。方法20例SAP患者在临床确诊4h内实施介入下的区域性动脉灌注生长抑素和抗生素等治疗,术后加压灌注5d;以全身药物治疗的28例患者作对照组,比较两种治疗方法对胰腺炎的临床指标和病死率、并发症率、住院时间等的影响。结果两组在胰腺炎的临床症状缓解、血尿淀粉酶和脂肪酶等炎症生化指标方面比较差异有统计学意义。区域灌注组患者的住院病程缩短,且病死率降低(P<0.05),其并发症率及中转手术率等方面与全身药物治疗组比较差异有统计学意义(P<0.05)。结论区域性动脉灌注治疗SAP能快速改善临床和生化指标,疗效明显优于全身用药治疗,可以在临床推广使用。

Objective To evaluate the potential of interventional regional arterial infusion for severe acute pancreatitis （SAP）. Methods Regional arterial infusion with somatostatin and antibiotic was performed in 20 cases of SAP within 4 hours after diagnosis confirmed, and pressurized infusion lasted for 5 days. Another 28 cases of SAP as control group received drug treatment all over the body. The SAP clinical data such as symptom, mortality, complication rate and stay time in hospital were analysed in two groups. Results There were significant differences in remission, serum amylase, urine amylase and lipase between the regional and total infusion groups. The stay time in hospital, mortality, complication and operation rate were lower in regional infusion group than those of control group（P〈0.05）. Conclusion Regional arterial infusion therapy can improve clinical and biochemical index of SAP quickly. The effect is obviously better than that of drug treatment all over the body, and it＇s worth recommending for clinical application.