乌司他丁联合CRRT治疗重症急性胰腺炎的效果观察

Observation of curative effect of ulinastatin combined with CRRT on severe acute pancreatitis

目的探讨乌司他丁联合连续性肾脏替代治疗(CRRT)对重症急性胰腺炎的治疗效果。方法回顾性分析2019年1月至2021年12月山西白求恩医院收治的67例重症急性胰腺炎患者的临床资料,其中单纯接受CRRT治疗的33例患者纳入常规组,开展乌司他丁联合CRRT治疗的34例患者纳入研究组。比较两组病情严重程度(急性生理和慢性健康状况Ⅱ评分)、恢复状况、治疗效果、临床指标(肌酐、淀粉酶、HCO3-)水平、炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及C-反应蛋白(CRP)]水平。结果研究组治疗后急性生理和慢性健康状况Ⅱ评分低于常规组,腹痛缓解、胃肠减压及重症监护治疗病房治疗时长均短于常规组(P均<0.05)。研究组总有效率(94.12%,32/34)高于常规组(75.76%,25/33),P<0.05。治疗后,研究组肌酐及淀粉酶含量低于常规组,HCO3-水平高于常规组(P<0.05)。治疗后,研究组IL-6、IL-10、TNF-α、CRP水平均低于常规组(P均<0.05)。结论重症急性胰腺炎患者采用乌司他丁联合CRRT治疗可改善临床指标,延缓病情进展,减轻机体炎症反应,提高治疗效果。

Objective To investigate the curative effect of ulinastatin combined with continuous renal replacement therapy(CRRT)on severe acute pancreatitis.Methods The clinical data of 67 patients with severe acute pancreatitis treated in Shanxi Bethune Hospital from January 2019 to December 2021 were analyzed retrospectively.Of them,33 patients treated by CRRT alone were included in the routine group,and 34 patients treated by ulinastatin combined with CRRT were included in the study group.The disease severity(acute physiology and chronic health evaluation-Ⅱscore),recovery condition,efficacy,levels of clinical indicators,including creatinine,amylase and HCO3-,levels of inflammatory factors,including interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP),of the two groups were compared.Results After treatment,the acute physiology and chronic health evaluation-Ⅱscore of the study group was significantly lower than that of the routine group,and the duration of abdominal pain relief,gastrointestinal decompression and intensive care unit treatment were shorter than those of the routine group(all P<0.05).The total effective rate of the study group(94.12%,32/34)was significantly higher than that of the routine group(75.76%,25/33),P<0.05.After treatment,the levels of creatinine and amylase of the study group were lower than those of the routine group,and level of HCO3-was higher than that of the routine group(P<0.05).After treatment,the levels of IL-6,IL-10,TNF-αand CRP of the study group were lower than those of the routine group(all P<0.05).Conclusions Ulinastatin combined with CRRT,in the treatment of sever acute pancreatitis,can improve the clinical indicators,alleviate disease progress,decrease inflammatory reactions and promote therapeutic effect.