胰岛素疗法治疗重症急性胰腺炎的疗效及对炎症状态的影响  

The effect of insulin therapy on the acute severe pancreatitis and its effect on inflammatory state

作　　者：朱卫华 胡婷婷 ZHU Weihua;HU Tingting(Department of Critical Medicine,Center Hospital of EnshiTujia and Miao Autonomous Prefecture,Enshi,445000,China)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院重症医学科,湖北恩施445000

出　　处：《中国中西医结合消化杂志》2021年第4期280-283,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:探讨胰岛素疗法治疗重症急性胰腺炎(SAP)的疗效及对炎症状态的影响。方法:选取2017年6月—2019年6月收治的SAP患者120例,依据随机数字表分为胰岛组和常疗组,每组60例。常疗组给予常规疗法,胰岛组在此基础上给予胰岛素疗法,比较2组炎症状态(CRP、TNF-α、IL-6)、血和尿淀粉酶(AMS)、临床症状(腹痛、腹胀、恶心呕吐、腹膜刺激征缓解时间)、治疗疗效、死亡、不良反应。结果:胰岛组和常疗组治疗后CRP、TNF-α、IL-6、血和尿AMS明显低于治疗前,胰岛组治疗后CRP、TNF-α、IL-6、血和尿AMS明显低于常疗组,差异有统计学意义(P<0.05);胰岛组腹痛、腹胀、恶心呕吐、腹膜刺激征缓解时间明显低于常疗组,差异有统计学意义(P<0.05);胰岛组治疗有效率明显高于常疗组,差异有统计学意义(P<0.05),胰岛组和常疗组死亡率、不良反应率比较,差异无统计学意义(P>0.05)。结论:胰岛素疗法可有效改善SAP患者炎症状态、血和尿AMS,缓解了患者临床症状,提高了疗效,且安全性好。Objective:To discuss the effect of insulin therapy on the acute severe pancreatitis(SAP)and its effect on inflammatory state.Methods:120 patients with SAP from June 2017 to June 2019 were selected,they were divided into insulin group and routine group according to the random number table,60 cases in each group.The routine group was given routine therapy,the insulin therapy group was given insulin therapy on this basis,the inflammatory status,C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),blood and urine amylase(AMS),clinical symptoms,abdominal pain,abdominal distention,nausea and vomiting,peritoneal irritation syndrome relief time,therapeutic efficacy,death and adverse reactions were compared between the two groups.Results:The CRP,TNF-α,IL-6,blood and urine AMS in insulin group and routine group after treatment were significantly lower than those before treatment,the CRP,TNF-α,IL-6,blood and urine AMS in insulin group after treatment were significantly lower than those in routine group,the difference was statistically significant(P<0.05).The relief time of abdominal pain,abdominal distention,nausea and vomiting,peritoneal irritation sign in insulin group was significantly lower than that in routine group,the difference was statistically significant(P<0.05).The effective rate in insulin group was significantly higher than that in routine group,the difference was statistically significant(P<0.05),there was no significant difference in the death rate,adverse reaction rate between insulin group and routine group(P>0.05).Conclusion:Insulin therapy can effectively improve the inflammatory state,blood and urine AMS of patients with SAP,which can alleviate the clinical symptoms of patients,and it can improve the curative effect,and it has good safety.

关 键 词：胰岛素疗法 重症急性胰腺炎 炎症状态 疗效 安全性 

分 类 号：R576[医药卫生—消化系统]