低分子肝素及乌司他丁单用及联合治疗急性胰腺炎的效果及对肠道损伤保护分析.docVIP

低分子肝素及乌司他丁单用及联合治疗急性胰腺炎的效果及对肠道损伤保护分析 柳建华 李翔 大连市中心医院 湖南师范大学医学院 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的:研究低分子肝素和乌司他丁单用及联合治疗急性胰腺炎的疗效。方法:135例急性胰腺炎患者随机平均分为A、B、C三组, 均行常规治疗, A组加服低分子肝素, B组加服乌司他丁, C组联合应用两药, 对比三组症状治愈时间、转归、肠道黏膜屏障功能和炎症因子变化。结果:C组腹痛、呕吐、进食、体温、白细胞和血尿淀粉酶改善时间显著高于A、B两组, B组腹痛、呕吐、体温和血尿淀粉酶改善显著高于A组;A组缓解率80%, 重症化13.33%, 手术6.67%, B组分别为82.22%、11.11%和6.67%, C组分别为95.56%、2.22%和2.22%, C组缓解率显著高于A、B两组;治疗后三组DAO、D-乳酸和尿L/M值显著降低, 且降低幅度由高至低依次为C、B和A组;治疗后三组TNF-α和IL-1含量显著降低, IL-10含量显著升高, C组降低或升高幅度显著高于A、B两组, A、B两组TNF-α、IL-1差异显著。结论:低分子肝素联合乌司他丁治疗急性胰腺炎疗效较单用两药效果显著, 可显著改善患者肠道黏膜屏障功能, 降低炎症反应, 值得临床推广。 关键词： 低分子肝素; 乌司他丁; 急性胰腺炎; 肠道损伤保护; 作者简介：李翔, E-mail 收稿日期：2017-09-05 Effects of low molecular weight heparin and ulinastatin alone and combined use in the treatment of acute pancreatitis and the protection effect in intestinal injury Liu Jian-hua Li Xiang Department of Gastrointestinal Surgery Dalian Municipal Central Hospital Affilliated of Dalian Medical University; Medical College, Hunan Normal University; Abstract： [Abstact]Objective To study the effects of low molecular weight heparin and ulinastatin alone and combined use in the treatment of acute pancreatitis.Methods 135 patients with acute pancreatitis were randomly divided into group A, B and C, and all the patients were given routine treatment.Group A was additionally treated with low molecular weight heparin, while group B was treated with ulinastatin, and group C was treated with the combination of the two.The cure time of symptoms, outcome, intestinal mucosal barrier function and inflammatory factors were compared between groups.Results The relief of abdominal pain and vomiting, improvement of feeding, body temperature, white blood cell and urine amylase in group C were more significant than those in group A and group B, and the relief of abdominal pain, vomiting, fever and urine amylase in group B was more significant than that in group A;The remission rate, aggravation rate an