低分子肝素联合乌司他丁治疗急性胰腺炎的疗效分析

Therapeutic effect of low molecular weight heparin combined with ulinastatin on acute pancreatitis

目的分析低分子肝素联合乌司他丁治疗急性胰腺炎（acutepancreatitis，AP）的效果。方法2004年6月～2008年3月收治的100例AP患者，随机分入数量相等的4组：A组（对照组）、B组（低分子肝素治疗组）、C组（乌司他丁治疗组）、D组（低分子肝素＋乌司他丁治疗组）。观察各组第1、3、7天时的血自细胞计数、动脉血氧分压统计平均治愈天数、手术治疗率、重症化率和病死率。结果治疗第1天时低分子肝素可降低白细胞计数；在治疗第3、7天时低分子肝素、乌司他丁、低分子肝素协同乌司他丁均可降低白细胞计数。在治疗第3、7天时低分子肝素、乌司他丁、低分子肝素协同乌司他丁均可提高动脉血氧分压。低分子肝素及乌司他丁可缩短治疗天数，低分子肝素与乌司他丁对治疗天数无协同作用。结论低分子肝素联合乌司他丁治疗急性胰腺炎，可改善动脉咖氢分乐．隆低白绅晌计狮．缩橱病耪．

Objective To evaluate the therapeutic effect of low molecular weight heparin （LMWH） combined with ulinastatin （UTI） on acute pancreatitis （AP）. Methods One hundred age, and sex-matched AP patients were randomly divided into four equal groups： Group A （control group）, Group B undergoing subcutaneous injection of LMWH 5000 U every 12 h, Group C undergoing intravenous drip of UTI 100 000 U every 8 h, and Group D undergoing both LMWH＋UTI as described above. On days 1, 3, and 7 of the therapeutic course, WBC count and PaO2 were tested. The curative days, aggravation rates, operation rates, and mortality rates were also compared. Resu Its On day 1, treatment with LMWH decreased the WBC counts. On days 3 and 7, treatment with LMWH, UTI reduced the WBC counts alone, and there was synergistic reaction between LMWH and UTI. On days 3 and 7, LMWH, UTI could elevate the PaO2 alone, and there was synergistic reaction between LMWH and UTI. LMWH, UTI decreased the curative days alone, but there was no synergistic reaction between LMWH and UTI. Conc lus ion LMWH combined with UTI to cure the AP can improve PaO2, decrease WBC counts and curative days.