论文部分内容阅读
目的探讨乌司他丁联用奥曲肽对重症急性胰腺炎(severe acute pancreatitis,SAP)合并腹内高压(intra-abdominal hypertension,IAH)患者腹内压及血清炎性因子的影响。方法选取2013年8月—2016年8月收治的SAP合并IAH患者50例,随机分为对照组与观察组各25例。两组入院后均给予常规治疗,对照组在上述常规治疗基础上给予奥曲肽0.1 mg溶入20 ml生理盐水静脉注射,每8小时1次,3次/d,持续治疗1~2周。观察组在对照组基础上给予乌司他丁10万U溶入250 mL葡萄糖溶液静脉滴注,2次/d,治疗2周。分别于入院时及治疗第7、14天监测腹内压,检测白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、血淀粉酶、血小板活化因子(platelet activating factor,PAF)。对比分析两组并发症发生情况。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果治疗7、14 d观察组腹内压、IL-6、TNF-α、血淀粉酶、PAF均低于对照组(64.0%)(均P<0.05);与治疗7 d比较,治疗14 d两组以上指标变化更明显(均P<0.05)。观察组并发症发生率(28.0%)与对照组相比,差异有统计学意义(P<0.05)。结论乌司他丁与奥曲肽联用能加强对SAP合并IAH患者炎性细胞因子的抑制作用,降低腹内压及并发症发生率。
Objective To investigate the effect of ulinastatin combined with octreotide on the intra-abdominal pressure and serum inflammatory factors in patients with severe acute pancreatitis (SAP) and intra-abdominal hypertension (IAH). Methods Fifty patients with SAP complicated with IAH admitted from August 2013 to August 2016 were randomly divided into control group and observation group with 25 cases each. The two groups were given routine treatment after admission, the control group on the basis of the above conventional treatment given octreotide 0.1 mg dissolved in 20 ml saline intravenously, once every 8 hours, 3 times / d, continuous treatment for 1 to 2 weeks. On the basis of the control group, the observation group was given ulinastatin 100 000 U dissolved in 250 mL glucose solution intravenously, 2 times / d for 2 weeks. The intra-abdominal pressure was measured at admission and on the 7th and 14th day of treatment respectively. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) , Platelet activating factor (PAF). Comparative analysis of two groups of complications. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results Compared with the control group (64.0%), the intra-abdominal pressure, IL-6, TNF-α, blood amylase and PAF in the observation group on the 7th and 14th days were all significantly lower than those in the control group More than two groups of indicators more obvious changes (P <0.05). The incidence of complications in observation group (28.0%) was significantly higher than that in control group (P <0.05). Conclusion Combination of ulinastatin and octreotide can enhance the inhibitory effect of inflammatory cytokines in SAP patients with SAP and reduce the incidence of intra-abdominal pressure and complications.