低分子量肝素治疗重症急性胰腺炎的多中心前瞻性临床研究

目的探讨低分子量肝素（LMWH）治疗重症急性胰腺炎（SAP）的效果和对胰外器官的保护作用。方法将265例SAP患者随机分为常规治疗组（C组，130例）和常规治疗＋LMWH治疗组（LT组，135例），对比两组的有关临床指标和治疗效果。结果加用LMWH治疗后与C组比较，LT组APACHE11评分明显降低（P〈0．05），肝、肾功能明显改善（P〈0．05、P〈0．01），血钙升高显著（P〈0．05），胰腺损害的CT评分显著降低（P〈0．05），器官衰竭发生率明显下降（P〈0．01），而器官衰竭治疗成功率明显提高（P〈0．05），中转手术率和病死率均明显降低（P〈0．01）。结论在常规治疗基础上加用LMWH能有效提高SAP的治疗效果，降低病死率。

Low molecular weight heparin in the treatment of severe acute pancreatitis: a multiple center prospective clinical study

Objective To study the effect of low molecular weight heparin ( LMWH) in the treatment of severe acute pancreatitis(SAP) ,and the protective effect of LMWH on the function of the lung, liver, kidney and brain in SAP patients. Methods A multicentral prospective study on the treatment of SAP using LMWH was performed. Two hundred and sixty-five SAP patients were randomly divided into two groups:(1) Conventional treatment group (group C, n = 130); (2 ) Conventional treatment plus LMWH treatment group (group LT, n = 135). The clinical parameters and treatment results in the 2 groups were compared. Results After treatment, APACHE score in group LT was significantly lower than that in group C (P < 0. 05) , hepatic and renal function were much better (P < 0. 05, P < 0. 001, respectively), level of serum calcium was significantly elevated (P < 0. 05) , the CT SPN was much lower ( P < 0. 05 ) ; rate of organ failure significantly decreased (P < 0. 01 -0.01), the successful rate of organ failure treatment was increased (P < 0. 05) ; the conversion to operation and inhospital mortality decreased (all P < 0.001). Conclusions LMWH in combination with conventional treatment for SAP significantly improves the outcome and decreases the mortality of SAP.