血必净联合早期腹腔穿刺引流应用于重症急性胰腺炎病人的临床价值

Clinical application value of Xuebijing combined with early abdominal puncture and drainage in patients with severe acute pancreatitis

目的:探讨血必净联合早期腹腔穿刺引流治疗重症急性胰腺炎(SAP)病人的临床效果。方法:选择SAP病人60例,随机分为对照组和观察组,各30例。2组病人均给予SAP常规治疗,对照组单纯行腹腔穿刺术,观察组行腹腔穿刺术联合应用血必净。比较2组病人入院时和入院第3、5、7天白细胞(WBC)计数、C反应蛋白(CRP)、血清淀粉样蛋白(SAA)、肝素结合蛋白(HBP)、急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)、CT严重程度指数(CTSI),以及2组入住EICU时间和住院时间。结果:2组病人入院时WBC计数、CRP、SAA、HBP、APACHEⅡ评分、SOFA评分及CTSI评分差异均无统计学意义(P>0.05);入院第3天,2组上述指标均较入院时升高(P<0.05),随后在第5、7天降低(P<0.05),但观察组在第3天,除WBC计数与对照组差异无统计学意义(P>0.05)外,CRP、SAA、HBP、APACHEⅡ评分、SOFA评分和CTSI均低于对照组(P<0.05~P<0.01),第5、7天上述所有指标均低于对照组(P<0.05~P<0.01)。观察组EICU停留时间及住院时间均明显短于对照组(P<0.01)。结论:SAP病人在早期应用腹腔穿刺引流术联合血必净有助于减轻病人炎症反应,改善预后,缩短病人住院时间。

Objective:To investigate the clinical effects of Xuebijing combined with early paracentesis and drainage in the treatment of patients with severe acute pancreatitis(SAP).Methods:Sixty SAP patients were selected,and randomly divided into the control group and observation group(30 cases in each group).Both groups were given the conventional SAP treatment.The control group was treated with abdominal puncture alone,while the observation group was treated with abdominal puncture combined with Xuebijing.The white blood cell(WBC)count,C-reactive protein(CRP),serum amyloid protein(SAA),heparin-binding protein(HBP),acute physiology and chronic health score(APACHEⅡ),sequential organ failure score(SOFA)and CT severity index(CTSI)were compared between two groups at admission and on the third,fifth and seventh day after admission.The length of EICU stay and hospital stay in two groups were analyzed.Results:The differences of the WBC count,CRP,SAA,HBP,APACHEⅡscore,SOFA score and CTSI score between two groups were not statistically significant at admission(P>0.05).On the third day of admission,the above indexes of two groups increased compared with those on admission(P<0.05),and then which decreased on the fifth and seventh day(P<0.05).On the third day,the difference of the WBC count between two groups was not statistically significant(P>0.05),and the CRP,SAA,HBP,APACHEⅡ score,SOFA score and CTSI in observation group were lower than those in control group(P<0.05 to P<0.01).On the fifth and seventh day,all the above indexes in observation group were lower than those in control group(P<0.05 to P<0.01).The length of stay in EICU and hospital stay in observation group were significantly shorter than those in control group(P<0.01).Conclusions:The early application of paracentesis and drainage combined with Xuebijing in SAP patients can help reduce the inflammatory response,improve the prognosis,and shorten the hospitalization time of the patient.