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目的:评价生长抑素(somatostatin,商品名Stilamin,思他宁)和甲磺酸加贝酯(gabexate mesilate,GM)治疗急性胰腺炎患者的疗效,及这两种药物对急性出血坏死型胰腺炎的临床疗效。方法:采用随机对照研究,按是否出血坏死型随机分为治疗组和对照组,在常规治疗的基础上,分别接受思他宁或甲磺酸加贝酯治疗,并观察疗效。结果:思他宁用于治疗急性水肿型胰腺炎,总有效率达100.0%,痊愈率达78.9%,略高于对照组加贝酯(63.6%),但差异无显著性(P>0.05)。腹痛、上腹胀等症状均能在3～5d内基本缓解或消失。思他宁用于治疗急性出血坏死型胰腺炎,总有效率90%,高于对照组加贝酯66.7%,差异有显著性(P<0.05)。治疗过程中仅2例丙氨酸转氨酶轻度升高,未发现过敏、皮疹、白细胞明显下降等明显不良反应,肝、肾功能和电解质等生化指标和血常规监测显示其具有较好的安全性。结论:思他宁和加贝酯用于治疗急性水肿型胰腺炎和出血坏死型胰腺炎均有较好的疗效,不良反应较少。在急性水肿型胰腺炎治疗中,二者总有效率无显著性差异;在出血坏死型胰腺炎治疗中,思他宁总有效率高于加贝酯。
OBJECTIVE: To evaluate the efficacy of somatostatin (stilamin, stilamin) and gabexate mesilate (GM) in the treatment of acute pancreatitis in patients with acute hemorrhagic necrotizing pancreatitis The clinical efficacy. Methods: A randomized controlled study was randomly divided into treatment group and control group according to whether hemorrhagic or necrotic type was treated. On the basis of routine treatment, patients were treated with statin or gabexate mesylate respectively and the curative effect was observed. Results: Sitatin was used to treat acute edematous pancreatitis with a total effective rate of 100.0% and a cure rate of 78.9%, slightly higher than that of control group (63.6%), but the difference was not significant (P> 0.05) . Abdominal pain, abdominal distension and other symptoms can be basically relieved or disappear within 3 ~ 5d. Stilamin for the treatment of acute hemorrhagic necrotizing pancreatitis, the total effective rate of 90%, higher than 66.8% of the control group plus shell ethyl ester, the difference was significant (P <0.05). Only 2 cases of alanine aminotransferase slightly increased in the course of treatment, no obvious adverse reactions such as allergy, rash and significant decrease of white blood cells were found. The biochemical indexes such as liver and kidney function and electrolytes and blood tests showed that it had good safety . Conclusion: Statin and gabexate are effective in the treatment of acute edematous pancreatitis and hemorrhagic necrotizing pancreatitis, with less adverse reactions. In the treatment of acute edematous pancreatitis, the total effective rate was no significant difference in the treatment of hemorrhagic necrotizing pancreatitis, statin is always more effective than gabapentin.