乌司他丁联合奥曲肽治疗急性重症胰腺炎的临床研究

目的探讨乌司他丁联合奥曲肽治疗急性重症胰腺炎的疗效。方法将2011年6月～2012年6月来我院住院治疗的58例急性重症胰腺炎患者作为研究对象,分为观察组32例和对照组26例,两组患者均予禁食水、持续胃肠减压、抗炎,抑酸解轻、止痛和对症支持治疗。对照组予奥曲肽0.6 mg/24 h持续静脉滴注,病情缓减后改为0.1 mg,每8小时一次,肌肉注射。观察组同时加用乌司他丁10万U溶于10%葡萄糖250 mL静脉滴注,每12小时一次,连用5～7 d,奥曲肽用法同前,并于治疗后复查血常规,血、尿淀粉酶,观察比较两组的临床疗效及临床症状缓解情况、并发症。结果两组疗效比较差异有统计学意义（χ2=4.839,P〈0.05）。观察组总有效率93.75%,对照组总有效率73.08%,观察组的总有效率明显优于对照组。观察组的腹痛缓解时间、腹部压痛消失时间、血淀粉酶恢复时间、尿淀粉酶恢复时间均明显快于对照组,差异有统计学意义（P〈0.05）。结论乌司他丁联合奥曲肽治疗急性重症胰腺炎疗效确切,值得推广和应用。

Clinical study of ulinastatin and octreotide in treatment of severe acute pancreatitis

Objective To investigate the effect of ulinastatinand octreotide in treatment of severe acute pancreatitis.Methods From June 2011 to June 2012 in our hospital,58 acute severe pancreatitis patients were divided into observation group of 32 cases and a control group of 26 cases,two groups were given fasting,water and continuous decompression,anti-inflammatory,antacid solution light,pain and symptomatic and supportive treatment.Control group were given 0.6 mg/24 h continuous intravenous infusion of octreotide,disease mitigation later changed to 0.1 mg,every 8 hours,intramuscular injection.Observation group were added Ulinastatin 100,000 U dissolved in 10% glucose 250 mL intravenously every 12 hours,once every 5 to 7 days,octreotide usage with the former,and after the review of the treatment of blood,blood,urine amylase enzymes.The efficacy and clinical symptoms,complications were compared.Results The two groups were statistically significant differences in efficacy（χ2= 4.839,P 0.05）.Observation group ineffective 2 cases,the total effective rate was 93.75%,7 cases were ineffective in the control group,the total effective rate was 73.08%;The total effective rate of the observation group was significantly better than the control group.Time abdominal pain,abdominal tenderness disappeared time,recovery time of serum amylase and urine amylase recovery time of observation group was significantly faster than the control group,the difference was statistically significant（P 0.05）.Conclusion Ulinastatin and octreotide in treatment of acute severe pancreatitis have good efficacy,should be promoted and applied.