乌司他丁联合连续性血液净化治疗重症急性胰腺炎的临床疗效分析

Clinical efficacy of ulinastatin combined with continuous blood purification in the treatment of severe acute pancreatitis

目的探讨乌司他丁联合连续性血液净化治疗重症急性胰腺炎的临床疗效。方法选择2015年1月~2016年12月在我院诊断治疗的重症急性胰腺炎患者60例的临床资料进行回顾性分析。其中30例患者采用乌司他丁治疗为对照组,30例患者采用乌司他丁联合连续性血液净化的方法治疗为研究组。比较两组临床疗效,记录两组治疗前及治疗后48h急性生理学与慢性健康状况Ⅱ评分(APACHEⅡ)评分、血肌酐、PaO_2、MAP、血清CRP以及IL-6等水平。结果研究组总有效率70.0%,对照组总有效率43.3%,研究组显著高于对照组,差异有统计学意义(P<0.05)。两组治疗48h后,心率、血肌酐、CRP、IL-6以及APACHEⅡ评分均较治疗前显著下降,而MAP、PaO_2较治疗前显著升高,差异有统计学意义(P<0.05);治疗48h后,研究组心率、血肌酐、CRP、IL-6以及APACHEⅡ评分显著低于对照组,而MAP、PaO_2显著高于对照组,差异有统计学意义(P<0.05)。结论乌司他丁联合连续性血液净化治疗重症急性胰腺炎能够显著提高临床疗效,改善相关临床指标。

Objective To discuss clinical efficacy of ulinastatin combined with continuous blood purification in the treatment of severe acute pancreatitis. Methods Clinical data of a 60 cases with severe acute pancreatitis from Jan 2015 to Dec 2016 were retrospectively analyzed.30 cases of control group was treated with ulinastatin,and 30 cases of study group was treated with ulinastatin combined with continuous blood purification.Clinical efficacy of two groups was compared,and APACHE Ⅱ ,HR,serum creatinine,PaO2,MAP,serum CRP and IL-6 before and after treatment of 48h of two groups were recorded. Results Total effective rate of study group was 70.0%,control group was 43.3%,and the difference was statistically significant（P 〈 0.05）;After treatment of 48h, HR, serum creatinine,serum CRP,IL-6 and APACHE Ⅱ of two group were lower than those before treatment,MAP and PaO2 were higher than those before treatment,and the difference was statistically significant（P 〈 0.05）;After treatment of 48h,serum creatinine,serum CRP,IL-6 and APACHE Ⅱ of study group were lower than those of control group,MAP and PaO2 were higher than those of control group,and the difference was statistically significant（P 〈 0.05）. Conclusion Ulinastatin combined with continuous blood purification in the treatment of severe acute pancreatitis can improve clinical efficacy and relevant clinical indicators.