持续性区域动脉介入灌注生长抑素治疗重症急性胰腺炎疗效的CT与临床联合评价

CT associated with clinical indexes to evaluate therapeutic efficacy of continuous regional intra-arterial infusion of somatostatin for treatment of severe acute pancreatitis

目的 CT联合临床指标评价持续性区域动脉介入灌注生长抑素治疗重症急性胰腺炎(SAP)的疗效。方法 121例患者随机分为持续性区域灌注(CRI)组(60例)和常规给药组(61例),区域灌注组经股动脉超选择插管至胰腺坏死的供血动脉留置导管,用微泵持续24小时灌注生长抑素及抗生素,症状体征消失后拔管。常规给药组用静脉输注药物,药物剂量完全同区域灌注组。结果 SAP患者经过治疗,CRI组与常规给药组比较疗效显著,临床指标恢复时间缩短,腹痛症状消失时间(4.9±2.3)d vs(6.3±2.1)d、腹压痛消失时间(6.3±2.1)d vs(8.8±2.9)d、血淀粉酶恢复正常时间(8.7±1.9)d vs(9.5±1.6)d、平均住院时间(25.0±5.3)d vs(36.0±4.2)d(P<0.05或<0.01),Balthazar CT分级明显下降(有效率85.0%vs 68.9%)。结论 CRI灌注生长抑素治疗SAP的疗效肯定,是一种比较理想的治疗方法。

Objective The purpose of the study was to adopt CT associated with clinical indexes to evaluate the therapeutic efficacy of continuous regional intra-arterial infusion（CRI）of somatostatin and antibiotics in patients of severe acute pancreatitis（SAP）. Methods One hundred and twenty-one cases of SAP patients were randomly divided into two groups,CRI group with 60 cases and conventional treating group with 61 cases. In CRI group, antibiotics and somatostatins were pumped into the catheters in the bad flood supplying artery of pancreas from the catheter of femoral artery by a micro pump for 24 hours, and after the symptoms and signs of SPA patients disappeared, the catheters were moved out. In the conventional treating group, the same dose of antibiotics and somatostatins were given by intravenous infusion method. Results In SAP patients through the treatment, CRI group as compared with conventional group showed better effect, shortened the time for abdominal pain （4.9 ± 2.3） d vs （ 6.3 ± 2.1 ） d, abdominal tenderness （ 6.3 ± 2.1） d vs （8.8±2.9） d, hemodiastase to normal （8.7±1.9） d vs （9.5±1.6） d, and average hospitalization days （25.0±5.3） d vs （36.0±4.2） d,and Balthazar CT grade obviously decreased. Conclusion CRI of somatostatin for the treatment of SAP confirms the therapeutic efficacy as an ideal treatment.