肝素钠联合胰岛素治疗高脂血症性胰腺炎的临床疗效

Clinical Observation of Heparin Sodium Combined with Insulin in Treatment of Hyperlipidemic Pancreatitis

目的:分析持续泵控小剂量肝素钠注射液联合胰岛素注射液治疗高脂血症性胰腺炎患者的临床疗效。方法:选取2017年1月—2022年7月湖南益阳康雅医院收治的高脂血症性胰腺炎患者180例为观察对象,按照患者及家属的意见采用不同治疗方案,分为观察组103例与对照组77例。对照组采用血浆置换法治疗,观察组采取持续微量泵入小剂量肝素钠注射液联合胰岛素注射液治疗。比较两组患者血脂水平、临床相关指标、临床症状和体征缓解时间。结果:治疗后,观察组甘油三酯、总胆固醇水平均高于对照组,差异有统计学意义(P<0.001);治疗3d后,观察组白细胞计数、超敏C反应蛋白、D-D水平均高于对照组,差异有统计学意义(P<0.001);观察组腹痛、胃肠道功能、腹膜炎体征缓解时间均长于对照组,差异有统计学意义(P<0.05)。结论:因血浆置换法造价昂贵,为了减轻患者的负担,本次研究应用的肝素钠联合胰岛素治疗对缓解患者的临床症状、体征,改善微循环情况均有一定的效果。

Objective:To analyze the clinical efficacy of low dose heparin sodium injection combined with insulin injection in the treatment of hyperlipidemic pancreatitis.Methods:A total of one hundred and eighty patients with hyperlipidemic pancreatitis admitted to Hunan Yiyang Kangya Hospital from January 2017 to July 2022 were selected as the observation objects.According to the opinions of patients and their families,different treatment schemes were adopted,and they were divided into observation group(103 cases)and control group(77 cases).The control group was treated with plasma exchange,and the observation group was treated with low dose heparin sodium injection combined with insulin injection.The blood lipid levels,clinical indicators,and the remission time of clinical symptoms and signs were compared between the two groups.Results:After treatment,the levels of triglyceride and total cholesterol in observation group were higher than those in control group,the difference was statistically significant(P<0.001);After 3 days of treatment,the leukocyte count,hypersensitive C-reactive protein and D-D levels in the observation group were higher than those in the control group,with statistical significance(P<0.001);The remission time of abdominal pain,gastrointestinal function and peritonitis signs in the observation group was longer than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Due to the high cost of plasma exchange,in order to reduce the burden of patients,heparin sodium combined with insulin therapy used in this study has certain effects on alleviating clinical symptoms and signs of patients and improving microcirculation.