川芎嗪治疗胰腺相关性肺损伤临床疗效研究

Clinical research of tetramethylpyrazine for treating severe acute pancreatitis

目的探讨早期在重症急性胰腺炎(SAP)患者中使用川芎嗪(TMP)能否改善氧和,降低肺损伤发生率,提高生存率及缩短住院时间。方法将该院42例SAP患者分为两组,对照组(C组)21例,采用SAP常规治疗联合呼吸支持治疗;川芎嗪组(TMP组)21例,采用SAP常规治疗、呼吸支持治疗、川芎嗪治疗。结果气管插管C组共6例(28.57%),而TMP组仅为3例(14.28%);急性呼吸窘迫综合征(ARDS)C组9例(42.86%),TMP组为6例(28.57%),两组患者中,接受气管插管有创呼吸机支持治疗人数比较差异有统计学意义(P<0.05);C组生存率为80.95%,住院时间为(21.6±7.3)d,而TMP组生存率为85.71%,住院时间仅(17.9±6.4)d,两组患者在生存率方面比较差异无统计学意义(P>0.05),在平均住院时间上,TMP组具有明显优势(P<0.05)。结论早期TMP干预,明显减少气管插管率,有效降低ARDS发生率,缩短住院时间,但并未提高生存率。

Objective To investigate whether the early use of tetramethylpyrazine（TMP） could improve the oxygenation ,reduce the rate of pulmonary lesion ,increase the survival rate and shorten the hospital days in the patients with severe acute pancreatitis （SAP） .Methods A total of 42 patients with SAP were randomly divided into the control （C） group（21 cases ,receiving the conven-tional treatment combined with the respiratory support treatment ） .The TMP group（21 cases ,receing the conventional treatment , respiratory support and TMP treatment ） .Results In the C group ,6 cases were intubated（28 .57% ） ,9 cases were acute respiratory distress syndrome（ARDS）（42 .86% ） ,the survival rate was 80 .95% ,the average hospitalization was （21 .6 ＆#177; 7 .3）d;in the TMP group ,3 cases were intubated（14 .28% ） ,6 cases were ARDS（28 .57% ） ,the survival rate was 85 .71% ,the average hospitalization was（17 .9 ＆#177; 6 .4）d .The survival rate had no statistical difference between the two groups （P＆gt;0 .05） .In addition ,the TMP group was superior to the C group in the average hospital days .Conclusion Eerly TMP interrention significantly reduced the rate of endo-tracheal intubation and the occurrence rate of ARDS ,shorten the hospital days ,but without increasing the survival rate .