生长抑素联合生大黄芒硝治疗重症急性胰腺炎的疗效观察

目的探讨生长抑素联合生大黄、芒硝治疗重症急性胰腺炎（SAP）的临床疗效。方法47例SAP患者随机分为观察组（n=24）和对照组（n=23）。两组均给予抑酸护胃、胃肠减压、营养支持等常规内科综合治疗，对照组给予生长抑素8mg／d静脉泵入维持治疗，观察组给予生长抑素8mg／d静脉泵入维持联合生大黄灌注、芒硝外敷治疗。治疗前后观察两组病例临床症状及体征好转情况，检测两组白细胞计数、血清钙离子及血清淀粉酶的变化情况，疗程结束统计总有效率。结果两组多数患者临床症状及体征、实验室观察指标较治疗前明显改善（P〈0．05）。观察组首次排便时间、腹胀腹痛缓解时间较对照组明显缩短（P〈0．01）；治疗3d，两组实验室观察指标变化情况差异无统计学意义（P〉0．05），治疗7d，观察组实验室观察指标优于对照组，差异有统计学意义（P〈0．05）。疗程结束时两组总有效率比较，观察组为83.3％，对照组为52．2％，观察组优于对照组，差异有统计学意义（P〈0．05）。结论生长抑素联合生大黄、芒硝治疗SAP能有效缓解症状，提高临床疗效，可作为临床常规治疗手段。

Objective To investigate the clinical efficacy of somatostatin combined with rhubarb and mirabilite in the treatment of sever acute pancreatitis （ SAP ） . Methods Forty-seven SAP patients were randomly divided into observation group （ n=24 ） and control group （ n=23 ） .Two groups were given anti-gastric care, gastrointestinal decompression, nutritional support and other conventional medical treatments.The control group was given somatostatin 8mg/d intravenous maintenance treatment, the observation group was given somatostatin 8mg/d intravenous maintenance treatment combined with rhubard and mirabilite.The clinical symptoms and signs of two groups were observed.The changes of white blood cell, serum calcium and serum amylase were measured, the total effective rate was analyzed before and after the treatment course. Results The clinical symptoms and signs of two groups were significantly improved （ P〈0.05 ） . The observation group was significantly shorter than the control group in the time of first defecation and the remission time of abdominal pain and distension （ P〈0.01 ） .After treatment for 3 days, there was no statistically significant difference between the two groups in the test indicators.After treatment for 7 days, the observation group was better than the control group in the test indicators, the difference was statistically significant （ P〈0.05 ） .At the end of treatment course, the total efficiency of observation group was 83.3%, while the control group was 52.2%, the observation group was better than the control group, and the difference was statistically significant （ P〈0.05 ） . Conclusion The somatostatin combined with rhubard and mirabilite in the treatment of SAP can effectively relieve the symptoms, improve the clinical curative effect, which can be used as a clinical routine therapy.