奥曲肽联合前列地尔治疗高脂血症性急性胰腺炎疗效及对患者胃肠功能恢复血淀粉酶阴转率的影响  

Effect of Octreotide combined with Alprostadil in the Treatment of Hyperlipidemic Acute Pancreatitis and the Effect on Gastrointestinal Function Recovery and Negative Conversion Rate of Blood Amylase

作　　者：叶丹 柯丽 张川[1] 乐涛[1] 江利东[1] YE Dan;KE Li;ZHANG Chuan(Third People's Hospital of Chengdu, Sichuan Chengdu 610031, China)

机构地区：[1]四川省成都市第三人民医院重症医学科

出　　处：《河北医学》2019年第12期1975-1978,共4页Hebei Medicine

基　　金：四川省卫生厅科研课题,(编号:100961630)

摘　　要：目的:观察奥曲肽联合前列地尔治疗高脂血症性急性胰腺炎(HAP)疗效及对患者胃肠功能恢复、血淀粉酶阴转率的影响。方法:选择2016年5月至2019年5月期间我院收治入院的100例HAP患者,按简单随机分组法分为两组,各50例。对照组给予前列地尔静脉滴注,观察组加用奥曲肽持续静脉泵入,持续给药10d。比较两组治疗5d、10d时血淀粉酶阴转率、胃肠功能恢复、血淀粉酶恢复时间、住院时间、血清甘油三酯(TG)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CPR)及血液流变学指标水平,记录两组并发症发生情况。结果:对轻度患者,观察组治疗总有效率显著高于对照组,5d后观察组血淀粉酶阴转率显著高于对照组(P<0.05),而对重度患者,两组治疗总有效率及血淀粉酶阴转率比较无显著差异(P>0.05);观察组胃肠功能恢复情况、血淀粉酶恢复时间显著早于对照组,住院时间显著短于对照组(P<0.05);治疗后两组TG、IL-6、TNF-α、CRP及血液流变学指标水平均显著下降,且观察组低于对照组(P<0.05);观察组并发症发生率8.00%显著低于对照组22.00%(P<0.05)。结论:奥曲肽联合前列地尔治疗可有效降低HAP患者血脂水平,促进胃肠功能恢复,提高血淀粉酶阴转率,改善炎症反应及血液微循环状态,具有较高应用安全性。Objective: To observe the curative effect of octreotide combined with alprostadil in the treatment of hyperlipidemic acute pancreatitis(HAP) and the effect on gastrointestinal function recovery and negative conversion rate of blood amylase. Methods: A total of 100 patients with HAP admitted to the hospital from May 2016 to May 2019 were selected and divided into 2 groups by the random number table method, 50 cases in each group. Both groups were given standardized medical treatment after admission. The control group was treatment with intravenous infusion of alprostadil and the observation group was additionally treated with continuous intravenous infusion of octreotide for 10 days. The negative conversion rates of blood amylase after 5 days and 10 days of treatment, gastrointestinal function recovery, time for blood amylase recovery, length of hospital stay, levels of serum triglyceride(TG), interleukin-6(IL-6), tumor necrosis factor(TNF-α), C-reactive protein(CPR) and blood rheological indicators were compared between the two groups. The incidence of complications in both groups was recorded. Results: For mild patients, the total response rate of the observation group was significantly higher than that of the control group. The negative conversion rate of blood amylase in the observation group after 5 days of treatment was significantly higher than that in the control group(P<0.05). However, for severe patients, there was no significant difference in the total response rate or the negative conversion rate of blood amylase between the two groups(P>0.05). The time for gastrointestinal function recovery and blood amylase recovery in the observation group was significantly shorter than that in the control group. The length of hospital stay was also significantly shorter than the control group(P<0.05). The levels of TG, IL-6, TNF-α, CRP and blood rheological indicators in both groups were decreased significantly after treatment, and the levels were lower in the observation group than the control group(P<0.05). The

关 键 词：奥曲肽 前列地尔 高脂血症性急性胰腺炎 胃肠功能 血淀粉酶 

分 类 号：R47[医药卫生—护理学]