乌司他丁联合奥曲肽对急性胰腺炎的临床疗效及预后分析

Clinical effect and prognosis of ulinastatin combined with octreotide in acute pancreatitis

目的通过观察乌司他丁联合奥曲肽在急性胰腺炎患者中的临床治疗效果、相关炎性因子及血液动力学指标综合评价其在急性胰腺炎患者中的疗效。方法回顾性分析2015年1月-2016年3月在入院的急性胰腺炎患者113例,按入院时间分为2组,对照组44例单纯给予奥曲肽治疗,观察组69例给予乌司他丁联合奥曲肽治疗,治疗持续14d,通过观察2组患者体征恢复情况及治愈时间、治疗期间体内炎性因子水平及血液流变学变化情况综合分析评价乌司他丁联合奥曲肽对急性胰腺炎患者的治疗作用。结果治疗后,观察组患者腹痛、腹胀、恶心呕吐、腹膜刺激征缓解时间及急性胰腺炎治愈时间均短于对照组（P〈0.05）。观察组患者血浆比黏度、血小板粘附率及血栓长度均低于对照组（P〈0.05）,观察组在治疗7、14 d时血清C反应蛋白（CRP）水平明显下降并显著低于对照组（P〈0.05）,观察组患者治疗7、14d时体内肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）及白细胞介素-10（IL-10）显著降低（P〈0.05）。结论乌司他丁联合奥曲肽可快速缓解急性胰腺炎相关体征并缩短住院时间,同时改善血液微循环,显著降低体内C-反应蛋白及炎性因子水平,提高急性胰腺炎的临床治疗效果。

Objective To explore the efficacy and prognosis of ulinastatin combined with octreotide in treatment of acute pancreatitis.Methods 113 clinical patients with acute pancreatitis collected in January 2015 to March 2016 were retrospectively analyzed. Patients were divided into2 groups： 44 cases in the control group were treated with octreotide,69 cases in observation group treated with ulinastatin combined with octreotide for 14 days. The remission time signs and recovery,the levels of inflammatory factors and the changes of blood rheology during treatment were compared between 2 groups. Results After treatment,the remission time of abdominal pain and distension,nausea and vomiting,signs of peritoneal irritation and recovery time of acute pancreatitis in observation group were shorter than those in control group（P〈0. 05）. The plasma specific viscosity,platelet adhesion rate and thrombus length in observation group were lower than those in control group（P〈0. 05）. Compared with control group,the serum CRP level significantly decreased at 7 days and 14 days in observation group,the TNF-α,IL-6 and IL-10 significantly decreased at 7 days and 14 days in observation group（P〈0. 05）. Conclusion Ulinastatin combined with octreotide could rapidly relieve acute pancreatitis associated symptoms and shorten the hospitalization time,improve blood microcirculation disorder and reduce the levels of C-reactive protein and inflammatory factors,which could improve the efficacy.