乌司他丁治疗94例急性胰腺炎临床分析

The clinical understanding of ulinastatin in the therapy about acute pancreatitis

目的探讨微泵与非微泵静脉输注乌司他丁治疗重症急性胰腺炎疗效的差异及乌司他丁的最佳用药剂量。方法将94例重症急性胰腺炎患者随机分为两组,实验组(46例)应用微泵静脉输注乌司他丁;对照组(48例)乌司他丁经静脉全身给药。比较两组临床症状体征、实验室数据及远期并发症的差异。结果①实验组腹痛、腹胀、压痛消失的时间均短于对照组(P<005),中转急诊手术率低于对照组。②实验组患者的第3天、第7天血淀粉酶、尿淀粉酶、血糖、白细胞亦均低于对照组(P<0.05)。③并发症假性胰腺囊肿发生率两组无显著差异(P>0.05),与是否合用生长抑素密切相关(P<0.05)。结论微泵静脉输注乌司他丁治疗重症急性胰腺炎疗效好、剂量小。远期并发症的防治建议联合应用生长抑素。

Objective To approach the difference about ulinastatin using minipump intravenous infu- sion and not using minipump in the therapy about acute pancreatitis, discuss the proper dose of ulinastatin. Methods 94 severe acute pancreatitis patients were divided into 2 groups. The experiment group （46 cases） intravenous infused ulinastatin through the minipump, and the control group （48 cases ） did not use the minipump. The clinical symptom, physical sign, laboratory data and the long-term complications are compared. Results ①The experiment group patients＇ symptom and physical sign such as abdominal pain, abdominal dis- tension and tenderness disappear faster than the control group （ P 〈 0.05 ）. ②The 3-days blood amylase （BA） ,7- days blood amylase, urinary amylase, blood sugar, white blood cell of the experiment group are all lower than the control group（P 〈0. 05）. ③The happening rate of pancreatic pseudocyst between two groups has no differenee（P 〉0.05）, it is relate to using growth hormone release inhibiting hormone or not（P 〈0. 05）. Conclu- sion The curative effect of ulinastatin using minipump in the therapy about acute pancreatitis is fine, and the dose is little, combining growth hormone release inhibiting hormone is suggested to prevent the long-term com- plication.