重症急性胰腺继发感染患者区域灌注与全身给药的治疗效果观察  

Therapeutic effects of regional perfusion and systemic administration on patients with secondary infection of severe acute pancreatitis

作　　者：娄雪磊[1] 寇志平[1] 李世兴[1] 常祖宽[1] 石超珩 

机构地区：[1]新乡市中心医院介入科,河南新乡453000

出　　处：《中华医院感染学杂志》2016年第11期2538-2540,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点基金资助项目(123702322245)

摘　　要：目的探讨急性胰腺炎继发感染患者区域灌注和全身给药的治疗效果,以了解区域灌注对继发感染患者炎性因子、肝肾功能及血糖等的影响,旨在提高重症急性胰腺继发感染的临床疗效。方法收集医院2013年1月-2015年1月收治的重症胰腺炎继发感染患者76例,将其按照随机单盲取法分为对照组和观察组,各38例;对照组采用全身给药治疗,观察组在常规治疗基础上给予区域灌注治疗,观察两组患者治疗前及治疗3d谷丙转氨酶(ALT)、血肌酐(Scr)、血淀粉酶(AMY)、血糖、胰高血糖素及肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)的治疗效果。结果两组患者治疗前各项观察指标对比,差异无统计学意义;治疗后观察组各项指标均低于同组治疗前及对照组治疗后(P<0.05);观察组患者治疗总有效率100.00%,高于对照组81.58%,差异有统计学意义(P<0.05)。结论区域灌注对重症急性胰腺炎继发感染患者疗效优于全身给药,可迅速改善急性胰腺炎指标、改善血糖及胰高血糖素水平、降低炎性因子,值得临床推广。OBJECTIVE To discuss the effects of regional perfusion and systemic administration of acute pancreatitis with secondary infection,so as to understand the effects of the regional perfusion on inflammation factors of secondary infection,liver function,renal function and blood glucose,in order to improve the clinical efficacy of secondary infection of severe acute pancreatitis.METHODS A total of 76 patients with secondary infection of severe pancreatitis in hospital were collected from Jan.2013 to Jan.2015,and divided into 2groups by random single blind method,with 38 cases in each group.Patients in control group received systemic drug treatment,and those in observation group received regional perfusion therapy on base of routine treatment.Liver function indexes of alanine aminotransferase（ALT）,renal function indexes of serum creatinine（Scr）,serum amylase（AMY）,blood glucose,pancreas high blood sugar,inflammation index of tumor necrosis factor alpha（TNF-a）,leukocyte mediated IL-8（IL-8）,leukocyte mediated IL-6（IL-8）,and C-reactive protein（CRP）of two groups before and after treatment and 3days after treatment were detected.RESULTS The indexes of two groups before treatment had no significant difference,and the indexes of observation group after treatment were lower than those of observation group before treatment and those of control group after treatment（P〈0.5）.The total effectiveness of observation group was 100.00%,higher than that of the control group（81.58%）（P〈0.05）.CONCLUSION The effect of regional perfusion on patients with secondary infection of severe acute pancreatitis is better than systemic administration.The method can rapidly improve the indexes of acute pancreatitis,improve blood glucose and pancreatic hyperglycemia hormone levels,and reduce inflammatory factors,so it is worth promoting for clinic.

关 键 词：重症急性胰腺继发感染 患者 区域灌注 全身给药 

分 类 号：R657.51[医药卫生—外科学]