摘要
目的探讨重症急性胰腺炎(SAP)患者给予低分子肝素联合血液灌流治疗的临床效果。方法选取2019年2月至2021年3月商丘市第一人民医院收治的100例SAP患者作为研究对象,按照随机数字表法分成观察组(50例)与对照组(50例),对照组采用血液灌流治疗,观察组采用低分子肝素联合血液灌流治疗,比较两组临床疗效、症状和体征改善时间、肠道黏膜屏障指标、炎症因子水平、生理状况及28 d病死率。结果观察组(94.00%)与对照组(80.00%)相比治疗有效率更高,差异有统计学意义(P<0.05);观察组与对照组相比腹痛、呕吐、体温、肠鸣音改善时间更短,差异有统计学意义(P<0.05);两组治疗后D-乳酸(D-LA)、二胺氧化酶(DAO)、乳果糖/甘露醇(L/M)水平降低,差异有统计学意义(P<0.05),观察组与对照组相比更低,差异有统计学意义(P<0.05);两组治疗后白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平降低,差异有统计学意义(P<0.05),观察组与对照组相比更低,差异有统计学意义(P<0.05);两组治疗后急性生理与慢性健康Ⅱ(APACHEⅡ)评分降低,差异有统计学意义(P<0.05),观察组与对照组相比更低,差异有统计学意义(P<0.05);与对照组相比,观察组28 d病死率更低,差异有统计学意义(P<0.05)。结论SAP患者给予低分子肝素联合血液灌流治疗,能够提高临床疗效,缩短症状和体征改善时间,保护患者肠道黏膜屏障,改善炎症因子水平,改善生理状况,降低患者病死率。
Objective To investigate the clinical effect of low molecular weight heparin combined with hemoperfusion in patients with severe acute pancreatitis(SAP).Methods A total of 100 SAP patients who were admitted in Shangqiu First People's Hospital from February 2019 to March 2021 were selected as the research objects,and they were divided into the observation group(50 cases)and the control group(50 cases),according to the random number table method.The control group was treated with hemoperfusion,and the observation group was treated with low molecular weight heparin combined with hemoperfusion.The clinical efficacy,improvement time of symptoms and signs,intestinal mucosal barrier indexes,levels of inflammatory factors,physiological status and 28-day mortality of the two groups were compared.Results The total effective rate of treatment in the observation group(94.00%)was higher than the control group(80.00%)(P<0.05).The improvement time of abdominal pain,vomiting,body temperature and bowel sounds in the observation group was shorter than the control group(P<0.05).After treatment,the levels of D-lactic acid(D-LA),diamine oxidase(DAO),lactulose/mannitol(L/M)in the two groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the levels of interleukin-1(IL-1),interleukin-6(IL-6)and C-reactive protein(CRP)in the two groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the acute physiology and chronic healthⅡ(APACHEⅡ)scores of the two groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The 28-day mortality in the observation group was lower than the control group(P<0.05).Conclusion Low molecular weight heparin combined with hemoperfusion therapy for SAP patients can improve the clinical efficacy,shorten the symptoms and signs improvement time,protect the intestinal mucosal barrier,improve inflammatory factors levels,improve the physiological condition,and reduce the mortality rate of patients.
作者
赵国尧
ZHAO Guoyao(Department of Critical Care Medicine,The First People's Hospital of Shangqiu,Shangqiu Henan,476000,China)
出处
《临床研究》
2022年第7期101-104,共4页
Clinical Research
关键词
重症急性胰腺炎
低分子肝素
血液灌流
临床疗效
肠道黏膜屏障指标
炎症因子
severe acute pancreatitis
low molecular weight heparin
blood perfusion
clinical efficacy
intestinal mucosal barrier index
inflammatory factors
作者简介
赵国尧(1982-),男,汉族,山东菏泽人,主治医师,本科。研究方向:低分子肝素在重症胰腺炎抗凝治疗方面。
