早期区域动脉灌注5-氟尿嘧啶、奥曲肽治疗急性出血坏死性胰腺炎

目的为观察区域动脉灌注５－氟尿嘧啶（５－ＦＵ）、奥曲肽对急性出血坏死性胰腺炎的疗效，并对其大体病变严重度评估方法进行评价。方法将健康杂种犬１９只分成４组：对照组、５－ＦＵ组、奥曲肽组、５－ＦＵ＋奥曲肽组，各模型组经胃十二指肠动脉灌注生理盐水、５－ＦＵ、奥曲肽、５－ＦＵ联合奥曲肽进行治疗，按时序各抽血测定血清淀粉酶；动物死亡后即行尸体解剖。结果①各组模型前后血清淀粉酶水平明显上升，３个治疗组可使血清淀粉酶水平下降，其中以５－ＦＵ联合奥曲肽组作用最强；②对照组胰腺大体病变程度最严重，５－ＦＵ联合奥曲肽组最轻，５－ＦＵ组、奥曲肽组介于二者之间，其相互间无明显差异；③病理学检查结果与大体病变评估结果基本相符。结论①区域动脉灌注５－ＦＵ、奥曲肽是早期治疗急性出血坏死性胰腺炎的一种有效方法，联合应用疗效相互累加；②改良的张氏评估法能比较客观、准确地估计和评价实验犬胰腺炎病变严重程度，是一个理想的实验评价指标。

Regional intra-arterial infusion with 5-fluorouracil or octredide for treatment of acute necrotiaing pancreatitis

Objective To observe the therapeutic efficiency of intra-arterial infusion of 5-fluorouracil (5FU) or cotreotide for acute necrotizing pancreatitis and to evaluate the method of assessment of seventy. MethodsNineteen healthy outbred dogs were randomly divided into four groups: (1) control group; (2)5-FU group; (3)octreotide group; (4) 5-FU octreotide group. Dogs of these groups were separately given saline, 5-FU, octreotide, 5-FU combining with octreotide via gastropyploic artery. Blood samples were taken for determination ofserum amylase before laparotomy and at different times after injecting sodium taurocholate. respectively. All thedogs were necropsied immediately after death. Their tissues of pancreas were taken for pathological examination andthe severity of pancreatic pathological changes was evaluated by a modified Zhang's method. Results (1)Theserum amylase level of each group after establishment of the model was much higher than that of before it, and allkinds of treatment decreased the serum amylase level. The treatment with 5-FU combining combining octreotide had the most remarkable effectiveness; (2)The severity of pancreatic pathological changes were as follows: control group>5- FU group=octreotide group>5-FU octreotide group. There was no significant difference between 5-FU group and octreotide group; (3) The result of tissue examination coincided with the result of modified Zhang's method.Conclusion (1) Pancreatic regional intra-aterial infusion of 5-FU or octreotide is a kind of effective therapeuticmethod for acute hemorrhagic necrotizing pancreatitis in early stage, and the treatment with 5-FU combming oc octreotide has the most remarkable effectiveness; (2) The modified Zhang's method can evaluate exactly the severityof canine pancreatic pathological changes, so it is an ideal evaluation index.