低分子肝素钙改善急性胰腺炎患者胰腺血流灌注功能的观察  

Effect of low molecular weight heparin on the perfusion function of pancreas in patients with acute pancreatitis

作　　者：戴建忠 范辉[2] 张勤慧[3] 

机构地区：[1]江苏省南通市肺科医院消化内科,226003 [2]苏州大学附属第三医院消化内科 [3]南通大学附属医院医学影像中心

出　　处：《中国医药》2009年第12期975-977,共3页China Medicine

摘　　要：目的探讨低分子肝素钙对改善急性胰腺炎（AP）患者胰腺血流灌注的作用。方法将82例AP患者，其中重症急性胰腺炎（SAP）19例，轻症急性胰腺炎（MAP）63例，按就诊顺序分为常规治疗组40例和联合治疗组42例，以健康志愿者22例作对照组。常规治疗组采用常规治疗，联合治疗组采用常规治疗＋低分子肝素钙，以64层螺旋CT检测血流灌注参数血流量、血容量、平均通过时间（MTT）和表面通透性（PS）为观察指标。结果对照组血流量、血容量分别为（342．21±145．24）ml／（100g·min）、（27．20±8．32）ml／100g显著高于MAP组和SAP组（P〈0．05），同时MAP组血流量显著高于SAP组（P〈0．05）。常规治疗组AP患者经常规治疗后血流量、血容量较治疗前轻度升高，差异无统计学意义（P〉0．05）；联合治疗组AP患者治疗后血流量、血容量较治疗前明显升高，差异有统计学意义（P〈0．05）。联合治疗组患者平均治疗日程、住院日程和常规治疗组相比明显缩短（P〈0．05）。结论AP的CT灌注参数可以作为判断胰腺炎微循环严重程度的一个量化指标，早期使用低分子肝素钙治疗AP对改善胰腺血流灌注具有较好的作用。Objective To observe the effect of low molecular weight heparin （LMWH） on the perfusion function of pancreas in patients with acute pancreatitis （AP）. Methods Hemodynamic parameters included blood flow （ BF）, blood volume （ BV）, mean transmit time （ MTT）, and capilary permeability surface （ PS ）. A total of 82 patients with AP were randomly divided into conventional treatment group （ n = 40） and joint-treatment group （ n = 42）. Other 22 normal individuals were used as controlled group. The hemodynamic parameters of perfusion were measured by 64-slice spiral CT scanner. Results The BF, BV in controlled group were significantly higher than those in the cases with mild acute pancreatitis （P 〈 0.05 ） and severe acute pancreatitis （P 〈 0.05 ）. The BF in MAP group was significantly higher than that in SAP group （P 〈 0.05 ）. After treatment, the BF, BV in conventional treatment group were slightly increased （ P 〉 0.05 ）, meanwhile the BF, BV in joint-treated group were significantly increased （P 〈 0.05）. The average hospitalization and therapy time in joint-treated group were significantly shorter than those in conventional treatment group （P 〈 0.05）. Conclusion MSCT perfusion imaging may be a quantita- tive index to assess the severity of microcirculation in patients with AP. LMWH is effective to improve the blood perfusion in early treatment of AP.

关 键 词：急性胰腺炎 CT灌注成像 低分子肝素钙 

分 类 号：R576[医药卫生—消化系统]