局部动脉置管持续灌注乌司他丁治疗重症急性胰腺炎

目的；评价胰腺局部动脉置管持续灌注乌司他丁（UTI）早期治疗重症急性胰腺炎的疗效。方法：将43例重症急性胰腺炎患者随机分为治疗组和对照组，治疗组20例在确诊后立即行动脉介入，应用改良Seldinger法置导管于胰腺病变供血动脉，持续灌注乌司他丁；对照组23例经静脉全身应用乌司他丁，对比两组疗效。结果：治疗组病人第3d、第6d血淀酶（BA）、尿淀粉酶（UA）、血糖（BS）、尿素氮（BUN）、白细胞（WBC）均低于对照组（分别P〈0．05，P〈0．01）而血钙（Ca^2＋）高于对照组（P〈0．05）；治疗组腹部症状（腹痛、腹胀）体症（腹部压痛）消失时间短于对照组（P〈0．01）。治疗组并发症发生率低于对照组（P〈0．05）。结论：胰腺局部动脉置管持续灌注乌司他丁早期治疗重症急性胰腺炎较静脉用药有更好疗效，且并发症少。

Treatment of Severe Acute Pancreatitis with Continuous Infusing Ulinastatin through a Catheter Placed in Regional Artery

Objective:To evaluate the efficacy of continuous infusing ulinastatin(UTI) through a catheter, placed in regional artery, in patients with severe acute pancreatitis. Methods: Forty-three cases of severe acute pancreatitis (SAP) were divided into treatment group(20 cases) and control group(23 cases). Treatment group was treated with interventional therapy immediately after diagnosed. Selding's method was used,briefly placing a catheter in the artery, irrigating the inflamed area of the pancreas, and continuously infusing UTI; while in control group. UTI was infused by intra-venous infusion. The efficacy between the two groups was compared. Results: The value of blood amylase, urine amylase. blood sugar, blood uria nitrogen and white blood cell count were significantly lower but that of blood calcium was higher in treatment group than those in control group on the 3rd and 6th day after the treatment ( P<0.05,P<0.01,P<0.05 respectively). There was a significantly shorter duration of abdominal pain, abdominal distension and tenderness in treatment group than in control group (all P<0.01). The complications rate was lower in treatment group than in control group(P<0. 05). Conclusion: The treatment of severe acute pancreatitis by continuous infusing UTI through a catheter placed in regional artery offers better efficacy and lower complications rate than by intra-venous infusing UTI.