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.docxVIP

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 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，对比三组症状治愈吋间、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-a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- a、IL-1 差界显著。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 显箸，可显箸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-ina订qq. com 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 Affiliated 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 al 1 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 t wo. The cure time of symptoms, out come, intestinal mucosal barrier function and inflammatory factors were compared be twee n groups. Results The rel ief of abdom inal pain and vomit i ng, 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 and operation rate in group A were 80%, 13. 33%and 6. 67%, respecti