乌司他丁联合早期血液灌流治疗重症急性胰腺炎的临床疗效研究  

Study on clinical efficacy of ulinastatin combined with early blood perfusion in the treatment of severe acute pancreatitis

作　　者：李丽丽[1] 周超[1] LI Li-li;ZHOU Chao(Intensive Care Unit,Tai'an Central Hospital,Tai'an 271000,China)

机构地区：[1]青岛大学附属泰安市中心医院重症医学科,271000

出　　处：《中国实用医药》2024年第20期10-13,共4页China Practical Medicine

摘　　要：目的探讨乌司他丁联合早期血液灌流对重症急性胰腺炎的治疗效果。方法60例重症急性胰腺炎患者,按随机数字表法将患者分为研究组和对照组,各30例。对照组应用乌司他丁治疗,研究组在对照组基础上开展早期血液灌流治疗。对比两组治疗效果及治疗前后血清炎性因子、症状评分、免疫功能指标、生活质量评分。结果研究组总有效率96.67%高于对照组的80.00%(P<0.05)。治疗后,两组C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,且研究组CRP(5.89±1.06)mg/L、PCT(0.46±0.15)ng/ml、TNF-α(10.83±2.07)ng/L低于对照组的(7.02±1.27)mg/L、(0.69±0.23)ng/ml、(13.49±2.46)ng/L(P<0.05)。治疗后,两组腹痛、发热、恶心呕吐评分均比治疗前明显降低,且研究组腹痛评分(1.17±0.39)分、发热评分(1.06±0.31)分、恶心呕吐评分(1.16±0.40)分低于对照组的(1.58±0.43)、(1.52±0.48)、(1.61±0.45)分(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)/CD8^(+)比治疗前均明显升高,且研究组CD3^(+)(41.92±2.43)%、CD4^(+)/CD8^(+)(1.89±0.34)高于对照组的(38.05±2.18)%、(1.52±0.31)(P<0.05)。治疗后,两组生理、心理、环境和社会关系评分比治疗前均明显升高,且研究组生理评分(89.75±6.48)分、心理评分(89.07±6.02)分、环境评分(90.14±6.15)分和社会关系评分(89.96±6.27)分均高于对照组的(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分(P<0.05)。结论对重症急性胰腺炎患者实施早期血液灌流与乌司他丁联合治疗可增强临床效果,改善患者症状、炎症反应,提升免疫功能及生活质量。Objective To explore the effect of ulinastatin combined with early blood perfusion in the treatment of severe acute pancreatitis.Methods 60 patients with severe acute pancreatitis were divided into a research group and a control group using a random number table method,with 30 patients in each group.The control group was treated with ulinastatin,while the research group was treated with early blood perfusion based on the control group.Comparison was made on therapeutic effect,serum inflammatory factors,symptom score,immune function indicators,and quality of life scores before and after treatment between the two groups.Results The total effective rate of 96.67%in the study group was higher than 80.00%in the control group(P<0.05).After treatment,the levels of C-reactive protein(CRP),procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)in both groups were lower than those before treatment;the research group had CRP of(5.89±1.06)mg/L,PCT of(0.46±0.15)ng/ml,and TNF-αof(10.83±2.07)ng/L,which were lower than(7.02±1.27)mg/L,(0.69±0.23)ng/ml,and(13.49±2.46)ng/L in the control group(P<0.05).After treatment,the scores of abdominal pain,fever,nausea and vomiting in both groups were significantly lower than those before treatment;in the research group,the abdominal pain score was(1.17±0.39)points,the fever score was(1.06±0.31)points,and the nausea and vomiting score was(1.16±0.40)points,which were lower than(1.58±0.43),(1.52±0.48),and(1.61±0.45)points in the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)/CD8^(+)in both groups were significantly higher than those before treatment;the study group had CD3^(+)of(41.92±2.43)%and CD4^(+)/CD8^(+)of(1.89±0.34),which were higher than(38.05±2.18)%and(1.52±0.31)in the control group(P<0.05).After treatment,the physiological,psychological,environmental and social relationship scores in both groups were significantly higher than those before treatment;in the research group,the physiological score was(89.75±6.48)points,the psychological score was(89.07±6.02)poi

关 键 词：重症急性胰腺炎 血液灌流 早期 乌司他丁 效果 

分 类 号：R576[医药卫生—消化系统]