乌司他丁联合生长抑素治疗急诊重症急性胰腺炎临床疗效观察

Clinical efficacy of ulinastatin combined with somatostatin in the treatment of severe acute pancreatitis in emergency department

目的研究乌司他丁联合生长抑素治疗急诊重症急性胰腺炎的临床疗效。方法选取2015年7月至2018年7月在我院接受治疗急诊重症急性胰腺炎患者88例,随机分为两组:两组均给予常规治疗,在此基础上,对照组44例给予生长抑素治疗,观察组44例给予乌司他丁联合生长抑素治疗,比较两组临床疗效、治疗前后实验室指标,记录患者呼吸恢复时间、心率恢复正常时间、腹痛缓解时间和住院时间,并统计不良反应发生情况。结果观察组治疗总有效率为90. 91%(40/44),显著高于对照组的79. 55%(35/44),差异比较有统计学意义(χ~2=4. 880,P <0. 05);两组治疗后的血清淀粉酶(AMS)、脂肪酶(LPS)、C反应蛋白(CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α水平均较治疗前显著降低(P <0. 05),且观察组低于对照组(P <0. 05);观察组呼吸恢复时间、心率恢复正常时间、腹痛缓解时间和住院时间均显著短于对照组(P <0. 05);观察组不良反应发生率为9. 09%(4/44),与对照组的4. 55%(2/44)比较无显著差异(χ~2=1. 229,P> 0. 05)。结论对于急诊重症急性胰腺炎患者,在常规治疗的基础上给予乌司他丁与生长抑素联合治疗效果确切,可显著改善患者实验室指标,抑制炎症反应,缩短患者临床症状改善时间,用药安全,值得推广应用。

Objective: To investigate the clinical efficacy of ulinastatin combined with somatostatin in the treatment of severe acute pancreatitis in emergency department and its impact on laboratory indicators and safety. Methods: Eighty-eight patients with severe acute pancreatitis treated in our hospital from July 2015 to July 2018 were randomly divided into two groups.The two groups were given conventional treatment. On this basis,44 patients in the control group were treated with somatostatin,and 44 patients in the observation group were given ulinastatin combined with somatostatin. The clinical efficacy and laboratory indicators before and after treatment were compared,respiratory recovery time,heart rate recovery time,abdominal pain relief time and hospitalization time were recorded,and the incidence of adverse reactions was counted. Results: The total effective rate of the observation group was 90. 91%( 40/44),which was significantly higher than that of the control group was79. 55%( 35/44),difference was statistically significant( χ2= 4. 880,P < 0. 05). Serum amylase( AMS),lipase( LPS),Creactive protein( CRP),interleukin( IL)-6,and tumor necrosis factor( TNF)-α levels were significantly lower in the two groups after treatment( P < 0. 05),and the observation group was lower than the control group( P < 0. 05);The respiratory recovery time,heart rate recovery time,abdominal pain relief time and hospitalization time were significantly shorter in the observation group than those in the control group( P < 0. 05). The incidence of adverse reactions in the observation group was9. 09%( 4/44),which was not significantly different from 4. 55%( 2/44) in the control group( χ2= 1. 229,P > 0. 05). Conclusion: For emergency patients with severe acute pancreatitis,the combination of ulinastatin and somatostatin is effective on the basis of conventional treatment,which can significantly improve the laboratory indicators,inhibit the inflammatory response,shorten the clinical symptom improvement time,and ensure the safety of medication.