不同剂量醋酸奥曲肽对重症急性胰腺炎患者临床疗效的影响  

Effect of different doses of octreotide acetate on clinical efficacy of patients with severe acute pancreatitis

作　　者：邢宝鹏[1] 李海峰[1] 金小渊 王洪[1] 

机构地区：[1]吉林大学第一医院二部急救医学科,吉林长春130031

出　　处：《中国中西医结合急救杂志》2017年第6期622-624,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的 观察醋酸奥曲肽不同给药剂量对重症急性胰腺炎（SAP）患者临床疗效的影响.方法 选择2013年9月至2016年1月在吉林大学第一医院二部急救医学科治疗的SAP患者90例,将患者按给药剂量不同分为奥曲肽小、中、大剂量组,每组30例.3组均给予基础治疗,奥曲肽小、中、大剂量组在基础治疗的同时用微量输液泵分别将奥曲肽0.2、0.3、0.4 mg加入0.9%氯化钠注射液100 mL中持续静脉泵入,每12 h给药1次,共使用20 d.比较3组临床症状（如腹痛、恶心、呕吐）好转时间、血淀粉酶恢复时间、住院时间和临床疗效,以及休克、肾功能不全等各种并发症的发生率的差异.结果 随着药物剂量的增加,奥曲肽小、中、大剂量组的症状好转时间（d）逐渐减少（分别为5.0±1.2、3.0±1.2、2.8±1.2）;血淀粉酶恢复时间、住院时间均以中剂量组最短,且明显短于大、小剂量组〔血淀粉酶恢复时间（d）：4.5±1.0比6.0±1.0和4.6±1.0,住院时间（d）：12.0±1.5比15.0±1.5和12.5±1.5〕;总有效率以中剂量组最高,高于大、小剂量组〔96.7%（29/30）比93.3%（28/30）和83.3%（25/30）;并发症发生率以小剂量组最高,高于中、大剂量组〔26.67%（8/30）比10.0%（3/30）和13.3%（4/30）〕.结论 采用微量输液泵静脉泵入奥曲肽,应用中等剂量的药物效果优于小剂量药物,而与大剂量组比较,效果无明显差异.Objective To observe the effect of different doses of octreotide acetate on the clinical efficacy of patients with severe acute pancreatitis （SAP）.Methods Ninety patients with SAP were admitted to the Department of First Aid Medicine Second Section of the First Hospital of Jilin University from September 2013 to January 2016, and according to difference in drug doses, they were divided into octreotide small dose, moderate dose and large dose groups, 30 cases in each group. All the three groups were given the basic treatment, and in the mean time octreotide 0.2, 0.3, 0.4 mg respectively was dissolved in 0.9 % sodium chloride 100 mL, then the low, moderate and high dose solutions were intravenously continuously infused by a micro pump into the veins of patients in respective small, medium and large dose groups, once every 12 hours, for a total of 20 days. The times of improvement of clinical symptoms （such as abdominal pain, nausea, vomiting）, blood amylase recovery time, hospitalization time and clinical efficacy, the incidence of shock, renal insufficiency and other complications were compared among the three groups.Results With the increase of drug dosage, the symptom improvement time （days） was gradually decreased （5.0±1.2, 3.0±1.2, 2.8±1.2） in small, medium and large dose groups, the recovery time of blood amylase and hospitalization time were the shortest in medium dosage group, less than those in large and small dosage groups [blood amylase recovery time （days）： 4.5±1.0 vs. 6.0±1.0, 4.6±1.0, hospitalization time （days） 12.0±1.5 vs. 15.0±1.5, 12.5±1.5], the total effective rate was the highest in the middle dosegroup, higher than those in the large and small dose groups [96.7% （29/30） vs. 93.3% （28/30）, 83.3% （25/30）]; the incidence of complications was the highest in the lowdose group, higher than those in the middle and large dose groups [26.67% （8/30） vs. 10.0% （3/30）, 13.3% （4/30）].Conclusions When using micro infusion pump for intravenous infusio

关 键 词：胰腺炎 重症 奥曲肽 量效关系 

分 类 号：R657.51[医药卫生—外科学]