乌司他丁预防胰十二指肠切除术后胰瘘的研究

A Contrast Study on Postoperative Administration of Ulinastatin Trypin Inhibitor to Prevent Pancreatic fistula in Patients Underwent Pancreatodudenectomy

目的 探讨乌司他丁 (Ulinastatintrypsininhibitor ,UTI)在胰十二指肠切除术后抑制胰液的分泌、预防和治疗胰瘘的作用。方法 对照组 :45例胰十二指肠切除术 ,术后未应用乌司他丁 ;实验组 :3 2例胰十二指肠切除术 ,术后常规应用乌司他丁 10万U溶于 2 5 0ml生理盐水 ( 2h内滴完 ) ,Bid ,连续用 5～ 8d。胰十二指肠切除术均采用Child术式。结果 对照组术后胰液分泌为( 2 48 5 6± 10 6 75 )ml/d ,实验组术后胰液分泌为 ( 13 8 2 6± 114 74)ml/d ,实验组术后胰液分泌比对照组显著减少 ,差异有显著性意义( P <0 0 5 )。对照组术后发生胰瘘 6例 ,未应用乌司他丁治疗 ,死亡 6例。实验组术后发生胰瘘 2例 ,常规应用乌司他丁治疗 ,无死亡病例。结论 乌司他丁用于胰十二指肠切除术术后抑制胰液分泌、预防胰十二指肠切除术后胰瘘的发生和治疗胰瘘疗效可靠 。

Objective To explore the effect of ulinastatin trypin inhibitor on inhibiting pancreatic secretion and preventing and curing pancreatic fistula in patients underwent pancreatodudenectomy.Methods 45 cases underwent pancreatodudenectomy were not given ulinastatin as control group postoperatively,32 patients underwent pancreatodudenectomy were intravenously driped by ulinastatin 100,000u solution in physiologic saline,every 12 hours (Bid) for 5～8days.Child's pancreatodudenectomy was adopted in all the cases. Results Pancreatic secretion at postoperative 120h in ulinastatin group (138 26±114 74)ml/d were significantly lower than those of control group (248 56±106 75)ml/d (P<0 05). Pancreatic fistula occurred in 6 cases in the contro1 group,6 cases died. Pancreatic fistula occurred in 2 cases in ulinastatin trypin inhibitor group,no death occurred. Conclusions Ulinastatin can definitely inhibit pancreatic secretion and prevent as well as cure pancreatic fistula in patients underwent pancreatodudenectomy. Postoperative administration of ulinastatin has clinical significance for reducing fistula occurrence and the mortality of pancreatodudenectomy.