乌司他丁治疗急性胰腺炎及其并发症的疗效观察

The Effect of Ulinastatin in Treatment of Acute Pancreatitis and its Complications

目的:探讨乌司他丁治疗急性胰腺炎的疗效及并发症情况。方法:64例急性胰腺炎患者根据入院先后顺序随机分为治疗组及对照组各32例,治疗组在常规治疗的基础上加用乌司他丁10万U溶于5%葡萄糖溶液250mL中静滴,8 h 1次,连续7d,观察比较两组的临床有效率、临床症状改善情况、两组治疗前后血尿淀粉酶变化情况及两组并发症及死亡率比较。结果:治疗组有效率明显高于对照组,差异有统计学意义。其中两组轻症患者经对症治疗后,有效率均达100.0%,但治疗组重症的有效率为94.12%,明显高于对照组的重症患者的有效率(57.14%),差异有统计学意义。治疗组的平均腹痛缓解时间、胰腺水肿消失时间、平均首次主动排便时间与对照组比较,差异有统计学意义(t值=2.967、2.126、2.254)。治疗前两组血尿淀粉酶比较,差异无统计学意义,经治疗后,两组均较治疗前比较,差异有统计学意义(P<0.05),且治疗组血尿淀粉酶的改变与对照组比较,差异也有显著性。两组并发症的发生率及死亡率分别比较,差异有统计学意义。结论:乌司他丁治疗急性胰腺炎有效率高,尤其对重症急性胰腺炎的治疗效果更好,能改善患者临床症状,降低并发症发生率,值得临床推广和应用。

Objective： To investigate the effect and concurrent complications of ulinastatin in treatment of acute pancreatitis.Method： 64 cases of acute pancreatitis patients were randomly divided into treatment group and control group,the treatment group plus ulinastatin 100 000 U dissolved in 250mL 5% glucose solution intravenously on the basis of conventional therapy,q8h、consecutive 7 days,and then observed and compared the clinical efficacy and clinical improvement in both groups,and the mortality rate of the two groups.Result： The healing effect of treatment group was significantly higher than that in control group,the difference has statistically significant.Two of these mild patients after symptomatic treatment,the efficient has reached 100%,the effective rate of severe patients in treatment group was 94.12%,significantly higher than those control group（57.14%）,the difference was statistically significant.The average time of abdominal pain,pancreatic edema disappeared,the average time for the first time active bowel movement of treatment group was lower than the control group,the difference was statistically significant（t=2.967,2.126,2.254）.The urine amylase comparment before treatment,the difference was not statistically significant,after treatment,both groups compared with before treatment,the difference was statistically significant（P 0.05）,and urine amylase in treatment group change compared with the control group,the difference was also significant.The complication incidence and mortality of two groups,the difference was statistically significant.Conclusion：Ulinastatin are efficient in treatment of acute pancreatitis,especially in treatment of severe acute pancreatitis,can improve clinical symptoms and reduce the incidence of complications,is worthy of promotion and application.