联用灯盏花素选择性动脉介入治疗老年重症急性胰腺炎的临床观察

Use of additive breviscapine in interventional selective arterial therapy for elderly patients with severe acute pancreatitis

目的:观察联用灯盏花素选择性动脉介入治疗老年重症急性胰腺炎患者的临床疗效。方法:将60例老年SAP患者(年龄≥60岁)随机分为观察组(32例)和对照组(28例),对照组采用奥曲肽与抗生素持续性胰腺区域动脉灌注,观察组采用以上灌注药物加用灯盏花素持续性胰腺区域动脉灌注,比较两组治疗效果。结果:治疗7 d后,两组APACHE II评分均较治疗前降低(均P<0.05),但观察组的APACHE II评分明显低于对照组(P<0.05);两组血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平均较治疗前明显降低(均P<0.05),但观察组两者的下降程度大于与对照组(均P<0.05)。观察组总并发症发生率明显低于对照组(34.38%vs.60.71%,P<0.05),观察组中转手术率与病死率均低于对照组(12.5%vs.21.5%;9.38%vs.14.29%),但差异无统计学意义(均P>0.05)。结论:联用灯盏花素选择性动脉介入治疗老年SAP具有良好的疗效。

Objective： To observe the clinical efficacy of additive elderly patients with severe acute pancreatitis （SAP）. breviscapine in interventional selective arterial therapy for Methods： Sixty elderly SAP patients （≥60 years of age） were randomly designated to observational group （32 cases） and control group （28 cases）. Patients in control group underwent continuous regional pancreatic-arterial infusion of octreotide and antibiotics, while those in observational group received continuous regional pancreatic-arterial infusion of the above infusion drugs plus breviscapine, The clinicalefficacies between the two groups were compared. Results： After 7-d treatment, the APACHE II scores in both groups were significantly decreased compared with those before treatment （both P〈O.05）, but were significantly lower in observational group than those in control group （P〈0.05）; the serum levels of tumor necrosis factor a （TNF-a） and interleukin 6 （IL-6） in both groups were significantly decreased compared with those before treatment （all P〈0.05）, but the decreasing degree of the two factors in observational group were both significantly greater than those in control group （both P〈O.05）. The overall incidence of complications in observational group was significantly lower than that in control group （34.38% vs. 60.71%, P〈0.05）, and though the surgery conversion rate and mortality in observational group were lower than those in control group （12.5% vs. 21.5%; 9.38% vs. 14.29%）, both differences reached no statistical significance （both P〉0.05）. Conclusion： Additive breviscapine in interventional selective arterial therapy has satisfactory efficacy for elderly SAPpatients.