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目的探讨经静脉滴注乌司他丁和Seldinger法区域动脉灌注乌司他丁在重症急性胰腺炎患者中的临床治疗效果。方法选取2013年1月至2015年10月诊治的100例重症急性胰腺炎患者作为研究对象,采用随机对照方法将患者分为对照组和试验组,各50例。在常规方法治疗的基础上,对照组联合静脉滴注乌司他丁治疗;试验组联合Seldinger法行区域动脉灌注乌司他丁治疗,治疗后21 d评价比较两组疗效。结果试验组治疗总有效率为96%,稍高于对照组(88%),但差异无统计学意义(χ~2=1.223,P>0.05);试验组治疗满意率为88%,稍高于对照组(80%)但差异无统计学意义(χ~2=1.190,P>0.05)。试验组治疗后腹痛缓解时间、肠鸣音恢复时间、首次排便时间以及住院时间,显著短于对照组(P均<0.01);两组患者治疗前血淀粉酶、尿淀粉酶、血清C-反应蛋白、天冬氨酸氨基转移酶(AST)水平及血WBC计数等水平相近(P均>0.05);试验组治疗后血淀粉酶、尿淀粉酶、血清C-反应蛋白、AST水平及血WBC计数等显著低于对照组(P均<0.05)。结论重症急性胰腺炎患者采用Seldinger法行区域动脉灌注乌司他丁治疗,用药安全方便,能够缩短临床症状和实验室指标恢复时间,效果较理想。能否获得有统计学意义的疗效提高,有待进一步扩大样本量继续观察。
Objective To investigate the clinical effects of intra-arterial infusion of ulinastatin and sedingerin in patients with severe acute pancreatitis by intravenous infusion of ulinastatin. Methods A total of 100 patients with severe acute pancreatitis who were diagnosed and treated from January 2013 to October 2015 were selected as study subjects. Patients were divided into control group and trial group with 50 cases in each group. On the basis of conventional treatment, the control group was treated with intravenous ulinastatin. The experimental group was treated with regional arterial infusion of ulinastatin by Seldinger’s method. The therapeutic effects were compared between the two groups 21 days after treatment. Results The total effective rate of the experimental group was 96%, slightly higher than that of the control group (88%), but the difference was not statistically significant (χ ~ 2 = 1.223, P> 0.05). The satisfaction rate of the experimental group was 88% In the control group (80%), the difference was not statistically significant (χ ~ 2 = 1.190, P> 0.05). The pain relief time, bowel sound recovery time, first defecation time and hospital stay in the experimental group were significantly shorter than those in the control group after treatment (P <0.01). Blood amylase, urine amylase, serum C-reaction Protein, aspartate aminotransferase (AST) level and blood WBC count (P> 0.05). After treatment, the levels of serum amylase, urine amylase, serum C-reactive protein, The counts were significantly lower than those in the control group (all P <0.05). Conclusion Severe acute pancreatitis patients using Seldinger regional arterial infusion of ulinastatin treatment, medication safe and convenient, can shorten the clinical symptoms and laboratory index recovery time, the effect is more satisfactory. The availability of statistically significant improvement in efficacy, pending further expansion of the sample size to observe.