硝酸甘油联合区域性动脉持续灌注治疗重症胰腺炎效果及对微循环障碍改善观察  

Effects of Nitroglycerin Combined with Regional Arterial Infusion on Severe Pancreatitis and Improvement of Microcirculation Disturbance

作　　者：连凌云[1] 李前进[1] 杨和平[1] 侯建峰[1] 牛福勇[1] 李福荣[1] 王晔飞 杜加录 张凯 刘志伟[2] 吴耀禄 

机构地区：[1]陕西省榆林市第一医院肝胆外科,榆林719000 [2]北京解放军总医院肝胆外科,北京100089 [3]延安大学第一附属医院,延安716000

出　　处：《陕西医学杂志》2018年第1期53-55,共3页Shaanxi Medical Journal

基　　金：陕西省榆林市科技计划项目(2014JH-21)

摘　　要：目的:探讨硝酸甘油联合区域性动脉持续灌注治疗重症胰腺炎的疗效,并观察对微循环障碍的改善作用。方法:收集重症胰腺炎患者68例,根据住院单双号随机分为对照组与观察组各34例。患者入院后均予以禁食禁饮、胃肠减压、抑酸、抗感染及纠正水电解质酸碱平衡等综合治疗;对照组在综合治疗上予以静脉滴注硝酸甘油,1次/d,共2d;观察组予以硝酸甘油联合区域性动脉持续灌注治疗,总疗程为7d。记录两组住院时间、腹痛缓解时间、腹胀缓解时间及肠功能恢复时间,并检测两组炎性因子水平,评估两组肝肾功能、血液流变学指标及并发症发生情况。结果:观察组住院时间、腹痛缓解时间、腹胀缓解时间及肠功能恢复时间均明显低于对照组(P<0.05);两组炎性因子IL-6、TNF-ɑ、ET及TXA2水平明显低于治疗前,且治疗后观察组各指标均优于对照组(P<0.05);治疗后两组血液流变学指标明显优于治疗前,且观察组均优于对照组(P<0.05)。结论:硝酸甘油联合区域性动脉持续灌注治疗重症胰腺炎临床疗效显著,可促进患者恢复健康,减少微循环障碍引起的器官衰竭等不良事件发生。Objective:To explore the effects of nitroglycerin combined with regional arterial infusion in the treatment of severe pancreatitis and to observe the improvement of microcirculation disturbance.Methods:68 cases of patients with severe pancreatitis enrolled in hepatobiliary surgery of our hospital were selected for the study and randomly divided into the control group and the observation group according to the single and odd number of admission.The patients after admission were treated with fasting,no drinking,gastrointestinal decompression,acid suppression,anti-infection,and correction of water and electrolyte and acid-base balance,and other comprehensive treatments.The control group was additionally treated with intravenous drip nitroglycerin for once a day with a total of 2 days,and the observation group was given nitroglycerin combined with regional continuous arterial infusion with the total course of treatment was 7 d.The treatment conditions,including hospital stays,abdominal pain relief time,abdominal distension relief time and intestinal function recovery time,were recorded between the two groups.And the levels of inflammatory factors were measured and the liver and kidney function and hemorheology were evaluated.At the same time the occurrences of complications were recorded between the two groups.Results:The hospital stays,the relief times of abdominal pain and abdominal distension and the recovery time of intestinal function in the observation group were significantly lower than those in the control group(P<0.05).The levels of IL-6,TNF-α,ET and TXA2 in the two groups were significantly lower than those before treatment,and after treatment the indexes in the observation group were superior to those in the control group(P<0.05).After treatment,the hemorheological indexes of the two groups were better than those before treatment,and the indexes levels in the observation group were better than those in the control group(P<0.05).After treatment,the levels of serum amylase,D-D,AST and Scr in the two groups

关 键 词：胰腺炎/药物疗法 硝酸甘油/治疗应用 ＠区域性动脉持续灌注治疗 ＠微循环障碍 

分 类 号：R657.5[医药卫生—外科学]