抗凝药物治疗重症急性胰腺炎的临床效果观察

Clinical Observation of Anticoagulant Agent Therapy for Acute Severe Pancreatitis

目的观察低分子肝素治疗重症急性胰腺炎(SAP)的临床效果.方法选择2014年1月至2016年1月云南省第三人民医院消化内科收治的SPS患者86例.按照随机数字表法随机分为治疗组和对照组,每组43例.对照组给予禁食、胃肠减压、抗炎、抑酸、使用生长抑素、乌司他丁及吸氧,心电监护等常规治疗,给予生大黄液灌肠,纠正酸碱、电解质平衡等治疗措施;治疗组在此基础上给予低分子肝素钙0.4 m L(相当于3 800IU抗Xa因子)皮下注射,12 h/次.治疗后,使用APACHE II评分等进行2组临床效果评价.结果与对照组相比,治疗组的死亡率9.3%较对照组死亡率14%有降低(P<0.05),治疗组的APACHE II评分(3.74±4.35)分较对照组APACHE II评分(7.65±5.36)分明显降低(P<0.05).结论低分子肝素用于SAP具有一定的临床治疗意义.

Objective To observe the clinical effect of low molecular weight heparin （LMWH） therapy for acute severe pancreatitis. Methods We selected 86 cases of acute pancreatitis patients, and randomly divided them into two groups： control group and treatment group, 46 patients in each group. Control group patients were given regular treatment, such as fasting, gastrointestinal decompression, anti-inflammation, acid-inhibitory, somatostatin, ulinastatin, and etc, and were also given the enema of rheum officinale liquid, remedying disequilibrium of Acid-alkali and electrolyte disturbance. Treatment group patients were on the basis of regular treatmerit given hypodermic injection with 0.4 mL LMWH （Equivalent 3 800 IU anti-Xa）, 12 hour per time. After therapy, we evaluated the clinical efficacy with APACHE II. Results The mortality and scores of APACHE II in treatment group were significantly lower than those in the control group. Conclusion Application of LMWH in treatment of acute pancreatitis acts quickly, has good curative effect, and is worthy of clinical application.