早期小剂量甲强龙治疗重症急性胰腺炎应用价值

Early low-dose methylprednisolone application in treatment of severe acute pancreatitis

目的探讨早期小剂量使用甲强龙治疗重症急性胰腺炎(SAP)应用价值。方法回顾性分析桂林市人民医院2002年1月至2010年6月在治疗的重症急性胰腺炎患者115例,分为研究组和对照组,两组患者在入院后均予采用重症急性胰腺炎常规综合治疗方案基础上予研究组早期注射甲强龙80mg/d,连续给药2～7d后停药,观察两组多个衡量SAP治疗效果的主要指标的差异。结果研究组在腹痛腹胀缓解时间、血淀粉酶恢复正常时间、血常规白细胞恢复正常时间、腹腔积液消退时间、出现急性肺损伤(ALI)及急性呼吸窘迫综合征(ARDS)等并发症比例、死亡率及平均住院日等衡量SAP治疗效果的主要指标均有明显改善。结论早期小剂量使用甲强龙治疗重症急性胰腺炎效果确定,值得推广。

Objective To explore the early application of the low-dose methylprednisolone in treatment of severe acute pancreatitis.Methods Retrospective analysis of 115 patients with severe acute pancreatitis in our hospital from January 2002 to June 2010,divided them into study group and control group,the two groups of patients with severe acute pancreatitis were administrated with the routine treatment.On this basis,the study group was additionally administrated with the injection of methylprednisolone 80mg / day,continuously 2~7 days and withdrawal,and observed the differences of the main indicators of treatment in both groups with multiple measures.Results Compared with the SAP treatment measures,such as the time of abdominal pain and bloating relief,blood amylase and white blood cells,back to normal,ascites subsided,the proportion of the acute lung injury（ALI） and acute respiratory distress syndrome（ARDS）,mortality and the average length of stay,the study group proved significant improvement. Conclusions The early application of low-dose methylprednisolone in treatment of severe acute pancreatitis was proved effective and worthy of promotion.