低分子肝素治疗重症急性胰腺炎的临床研究

Clinical study of low molecular weight heparin on patients with severe acute Pancereatitis

目的探讨低分子肝素在治疗重症急性胰腺炎患者中的应用价值。方法将90例重症急性胰腺炎患者随机分为观察组与对照组,每组45例,对照组给予常规保守治疗,观察组在对照组基础上加用低分子肝素治疗,对比两组患者临床疗效。结果治疗2周后,观察组CTSI评分、APACHE-Ⅱ评分、CRP、PCT均显著优于对照组(P<0.05或<0.01);且临床症状、体征恢复正常或改善时间及总住院时间均显著短于对照组(P<0.01或<0.05);观察组并发症发生率显著低于对照组(P<0.01),治疗过程中转手术率两组差异无显著性(P>0.05)。结论在常规保守治疗基础上加用低分子肝素可明显减轻重症急性胰腺炎患者疾病严重程度,快速缓解临床症状体征,同时并发症发生率较低,且无中转手术率的增加。

Objective To study the application value of low molecular weight heparin（LMWH） in treating patients with severe acute pancereatitis （SAP）. Methods 90 patients with SAP were randomly devided into the control group and the observation group with 45 cases in each group. The control group were given the conventional treatment,based on which the observation group were given additional LMWH. Then, the clinical effects were compared between the two groups. Results After two weeks of treatment, the CTSI scores, APACHE II scores, CRP and PCT of the observation group were significantly better than those of the control group （ P d0.05 or P 〈0.01） . and the observation group had much shorter time that clinical symptoms and physical signs needed to return to normal or improve and shorter length of stay than the control group（ P 〈0.01 or P 〈0.05）. In addition, the complication incidence of the observation group was significantly lower（ P 〈0.01）, but no significant difference was found in the rate of converting to surgery during the treatment between the two groups（ P 〈0.05）. Conclusion Based on the conservative treatment, the additional application of LMWH can significantly alleviate the severity of SAP and quickly relieve clinical signs and symptoms. Besides, such treatment has relatively low complication incidence and no increase in the rate of converting to surgery during the treatment.