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目的探讨低分子量肝素(LMWH)治疗重症急性胰腺炎(SAP)的效果和对胰外器官的保护作用。方法将265例SAP患者随机分为常规治疗组(C组,130例)和常规治疗+LMWH治疗组(LT组,135例),对比两组的有关临床指标和治疗效果。结果加用LMWH治疗后与C组比较,LT组APACHEⅡ评分明显降低(P<0．05),肝、肾功能明显改善(P<0．05、P<0．01)．血钙升高显著(P<0．05),胰腺损害的CT评分显著降低(P<0．05),器官衰竭发生率明显下降(P<0．01),而器官衰竭治疗成功率明显提高(P<0．05),中转手术率和病死率均明显降低(P<0．01)。结论在常规治疗基础上加用LMWH能有效提高SAP的治疗效果,降低病死率。
Objective To investigate the effect of low molecular weight heparin (LMWH) in the treatment of severe acute pancreatitis (SAP) and its protective effect on the pancreatic organ. Methods 265 patients with SAP were randomly divided into conventional treatment group (group C, 130 cases) and conventional treatment + LMWH treatment group (LT group, 135 cases). The clinical indexes and therapeutic effects were compared between the two groups. Results Compared with group C, the APACHEⅡscore of LT group was significantly lower (P <0.05) and liver and kidney function was significantly improved (P <0.05, P <0.01). (P <0.05), the CT score of pancreatic damage decreased significantly (P <0.05), the incidence of organ failure decreased significantly (P <0.01), while the success rate of treatment of organ failure increased significantly (P <0.05). The rate of operation and fatality rate were significantly lower (P <0.01). Conclusion The addition of LMWH on the basis of routine treatment can effectively improve the therapeutic effect of SAP and reduce the mortality.