血必净注射液联合胆道镜清创并置管引流对胰腺炎合并胰周感染患者疗效、炎性因子、APACHEⅡ评分的影响  

Effects of Xuebijing Injection Combined with Choledochoscope-guided Debridement and Catheter Drainage on Clinical Efficacy,Inflammatory Factors and APACHEⅡScore in Treatment of Patients with Pancreatitis Complicated by Peripancreatic Infection

作　　者：张昆鹏[1] 张晓愉[2] 李少一[1] 甄品 ZHANG Kun-peng;ZHANG Xiao-yu;LI Shao-yi;ZHEN Pin(Department of Hepatobiliary Surgery,the People's Hospital of Xingtai,Xingtai,Hebei 054001,China;Department of Neurology,the People's Hospital of Xingtai,Xingtai,Hebei 054001,China)

机构地区：[1]邢台市人民医院肝胆外科,河北邢台054001 [2]邢台市人民医院神经内科,河北邢台054001

出　　处：《解放军医药杂志》2021年第5期105-108,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：邢台市科技计划项目(2017ZC113)。

摘　　要：目的分析血必净注射液联合胆道镜清创并置管引流治疗胰腺炎合并胰周感染患者的临床效果及对炎性因子、急性生理及慢性健康状况评价系统Ⅱ(APACHEⅡ)评分的影响。方法选取2015年3月—2020年6月我院收治的86例胰腺炎合并胰周感染患者,按治疗方法的差异分为研究组和对照组各43例。对照组予胆道镜清创并置管引流,研究组在对照组基础上联合血必净注射液治疗。比较2组临床疗效,治疗前后炎性因子水平、免疫因子水平、APACHEⅡ评分,以及术后并发症发生情况。结果研究组总有效率明显高于对照组(P<0.01)。治疗后,2组白细胞介素-6、肿瘤坏死因子-α及C反应蛋白水平均较治疗前明显下降,且研究组低于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗后,研究组免疫球蛋白A、免疫球蛋白G、免疫球蛋白M水平均较治疗前明显升高,且亦高于对照组治疗后,差异有统计学意义(P<0.05或P<0.01)。治疗后,研究组APACHEⅡ评分较同组治疗前及对照组均降低(P<0.05或P<0.01)。研究组住院时间明显短于对照组(P<0.01)。术后研究组切口感染、腹腔感染、组织损伤、出血发生率明显低于对照组(P<0.05)。结论胰腺炎合并胰周感染患者采用血必净注射液联合胆道镜清创并置管引流治疗临床效果佳,可在显著降低炎性因子水平、提升免疫功能的同时,降低APACHEⅡ评分,且安全性好。Objective To analyze clinical efficacy of Xuebijing Injection combined with choledochoscope-guided debridement and catheter drainage in treatment of patients with pancreatitis complicated by peripancreatic infection and its effects on inflammatory factors and acute physiology and chronic health evaluation systemⅡ(APACHEⅡ)score.Methods A total of 86 patients with pancreatitis complicated by peripancreatic infection admitted during March 2015 and June 2020 were selected and divided into research group(n=43)and control group(n=43)according to different treatment methods.Control group was given choledochoscope-guided debridement and catheter drainage,while research group was added Xuebijing Injection on the basis of treatment for control group.Clinical efficacy,levels of inflammatory factors,immune factors and APACHEⅡscore before and after treatment,and incidence rate of postoperative complications were compared between two groups.Results The total effective rate in research group was significantly higher than that in control group(P<0.01).After treatment,levels of interleukin-6,tumor necrosis factor-α and C-reactive protein were significantly lower than those before treatment in two groups,and the levels in research group were significantly lower than those in control group(P<0.05 or P<0.01).After treatment,in research group,levels of immunoglobulin(Ig)A,IgG and IgM were significantly higher than those before treatment in the same group,and the levels were also significantly higher than those in control group after treatment(P<0.05 or P<0.01).After treatment,APACHEⅡscore in research group was significantly lower than those before treatment in the same group and in control group(P<0.05 or P<0.01).Length of hospitalization in research group was significantly shorter than that in control group(P<0.01).Incidence rates of incision infection,infection of abdominal cavity,tissue injury and bleeding in research group were significantly lower than those in control group(P<0.05).Conclusion Xuebijing Injection combine

关 键 词：胰腺炎 胰周感染 血必净注射液 胆道镜 置管引流 白细胞介素-6 C反应蛋白 

分 类 号：R576[医药卫生—消化系统]