低分子肝素联合强化胰岛素在基层医院治疗高脂血症性急性胰腺炎的临床观察

The Clinical Effect of Using Low Molecular Heparin Combine with Intensive Insulin to Treat Acute Pancreatitis with Hyperlipidemia in Primary Hospital

目的:探讨低分子肝素联合强化胰岛素在基层医院治疗高脂血症性急性胰腺炎的临床疗效。方法:将128例临床诊断高脂血症急性胰腺炎患者分为常规治疗组(A组)、强化胰岛素治疗组(B组)、低分子肝素治疗组(C组)和联合用药组(D组),各组分别在患者入院时以及治疗1、3、5、7、14d后检测患者白细胞计数、血清hs-CRP水平、血清IL-6水平,记录各组患者胃肠道功能恢复时间、住院时间。结果:联合用药组在治疗3、5、7、14d后,白细胞计数、血清hsCRP水平和血清IL-6水平较常规治疗组和两组单独用药组明显降低(P <0. 05),联合用药组患者的胃肠功能恢复时间和住院时间较常规治疗组和两组单独用药组明显减少(P <0. 05)。结论:在基层医院采用联合低分子肝素和强化胰岛素的方案治疗高脂血症性急性胰腺炎,能够发挥协同作用,显著提高治疗高脂血症急性胰腺炎的疗效,加速患者康复,操作简便,适合在基层医院推广。

Objective:To research the clinical effect of using low molecular heparin combine with intensive insulin to treat acute pancreatitis with hyperlipidemia.Methods:128 cases of clinical diagnosed acute pancreatitis patients with hyperlipidemia were divided into conventional treatment group(group A),intensive insulin group(group B),low molecular heparin group(group C)and combination of low molecular heparin and intensive insulin group(group D).White blood cell count,serum level of hs-CRP and IL-6 were tested on admission,1,3,7 and 14 days after treatment.The recovery time of gastrointestinal function and hospital stay were recorded and compared between each group.Results:To compare with the conventional treatment group and single medication group,the combined medication group can significantly reduce WBC count,serum level of hs-CRP and IL-6 of acute pancreatitis patients with hyperlipidemia(P﹤0.05),and shorten the recovery time of gastrointestinal function and hospital stay(P﹤0.05).Conclusion:For the patients with acute pancreatitis and hyperlipidemia,treatment combined the conventional one with low molecular heparin and intensive insulin can significantly improve the therapeutic effect and enhance recovery.