低分子量肝素钙联合胰岛素泵治疗高脂血症性胰腺炎的临床研究

Clinical study of Low Molecular Weight Heparin Calcium combined with Insulin pump in the treatment of hyperlipidemic pancreatitis

目的探讨低分子量肝素钙联合胰岛素泵治疗高脂血症性胰腺炎的应用效果。方法选取2019年9月—2020年9月的广州市番禺区第二人民医院内科收治的56例高脂血症性胰腺炎患者作为研究对象,按照随机数字表法将其分为对照组和研究组,每组各28例。对照组采用禁食、补液、抗炎、胰岛素和葡萄糖等治疗,研究组在此基础上采用胰岛素泵和低分子量肝素钙治疗。比较两组患者治疗前后的活化部分凝血酶原时间(APTT)和凝血酶原时间(PT)变化情况,治疗后腹胀改善时间、腹痛改善时间和住院时长,治疗前及治疗4、7 d后的超敏C反应蛋白(hs-CRP)、三酰甘油(TG)、D-二聚体(D-D)、白细胞计数(WBC)水平变化情况以及治疗效果。结果两组治疗前后的APTT和PT比较,差异无统计学意义(P>0.05);研究组腹胀改善时间、腹痛改善时间、住院时长均短于对照组,差异有统计学意义(P<0.05);研究组治疗4、7 d后hs-CRP、TG、D-D、WBC水平均低于对照组,差异有统计学意义(P<0.05);研究组的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论高脂血症性胰腺炎联合应用胰岛素泵和低分子量肝素钙治疗效果理想,可以降低机体内的hs-CRP、TG、D-D、WBC,加速症状的改善,缩短住院时长,从而提高治疗效果,值得推广和应用。

Objective To explore the application effect of Low Molecular Weight Heparin Calcium combined with Insulin pump in the treatment of hyperlipidemia pancreatitis.Methods A total of 56 patients with hyperlipidemia pancreatitis in the Department of Internal Medicine of the Second People′s Hospital of Panyu Guangzhou from September 2019 to September 2020 were selected as the research subjects,and they were divided into the control group and the study group by the random number table method,with 28 cases in each group.The control group was treated with fasting,fluid replacement,anti-inflammatory,Insulin and glucose,and the study group was treated with Insulin pump and Low Molecular Weight Heparin Calcium on this basis.The changes of activated partial thrombin time(APTT)and prothrombin time(PT)before and after treatment,the improvement time of abdominal distension after treatment,the improvement time of abdominal pain and the length of hospital stay,the levels of high-sensitivity C-reactive protein(hs-CRP),triacylglycerol(TG),D-dimer(D-D),white blood cell count(WBC)before treatment,4,7 days after treatment and treatment effects after days were compared between the two groups.Results There were no statistically significant differences in APTT and PT between the two groups before and after treatment(P>0.05).The improvement time of abdominal distension,abdominal pain,and length of hospital stay in the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The hs-CRP,TG,D-D,and WBC levels of the study group were lower than those of the control group after 4 and 7 days of treatment,and the differences were statistically significant(P<0.05);The total treatment effective rate of the study group was higher than that of the control group,with statistical significance(P<0.05).Conclusion The combined application of Insulin pump and Low Molecular Weight Heparin Calcium in the treatment of hyperlipidemic pancreatitis has an ideal effect,which can reduce the hs-CRP,TG,D-D and WBC in the body,accelerate the improvement of symptoms,shorten the length of hospitalization,and thus improve the treatment effect.Therefore,it is worthy of promotion and application.