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目的:探讨联合应用生长抑素和泮托拉唑治疗急性重症胰腺炎的临床效果及安全性。方法:采用随机数字表法将我院2009年10月～2012年2月收治的96例急性重症胰腺炎患者分成两组。其中一组为对照组(48例),对照组患者接受禁食、抗生素预防、胃肠减压、营养支持和纠正代谢紊乱等常规治疗,另外一组为实验组(48例),实验组患者在对照组患者进行常规治疗的基础上加用生长抑素和泮托拉唑进行治疗。治疗2周后,比较两组患者治疗前后的血清IL-8、TNF-α水平、治疗的总有效率、腹痛腹胀症状消失的时间、血淀粉酶和白细胞计数恢复正常的时间以及不良反应的发生情况。结果:①在对照组患者中,治疗有效的患者有35例,治疗的总有效率为72.9%。在实验组患者中,治疗有效的患者有45例,治疗的总有效率为93.8%。实验组患者治疗的总有效率明显高于对照组患者治疗的总有效率,且两组间的差异具有显著性(p<0.05)。②实验组患者腹痛腹胀症状消失的时间、血淀粉酶和白细胞计数恢复至正常的时间均明显短于对照组患者,且两组间的差异具有显著性(p<0.05)。③治疗后两组患者的血清IL-8、TNF-α水平均较治疗前明显下降,且实验组患者的下降幅度明显大于对照组患者的下降幅度(p<0.05)。④在治疗期间,两组患者均未出现严重的不良反应。结论:联合应用生长抑素和泮托拉唑治疗急性重症胰腺炎具有疗效好、疗程短、不良反应发生率低等优点,可作为临床上治疗急性重症胰腺炎的首选方法加以推广和应用。
Objective: To investigate the clinical effect and safety of combination of somatostatin and pantoprazole in the treatment of acute severe pancreatitis. Methods: A total of 96 patients with acute severe pancreatitis treated in our hospital from October 2009 to February 2012 were divided into two groups by random number table. One group was the control group (48 cases). The control group received routine therapy such as fasting, antibiotic prophylaxis, gastrointestinal decompression, nutrition support and metabolic disorders correction. The other group was the experimental group (48 cases). The experimental group In the control group of patients on the basis of conventional treatment plus somatostatin and pantoprazole for treatment. After 2 weeks of treatment, the levels of serum IL-8 and TNF-α before and after treatment were compared, the total effective rate of treatment, the disappearance of abdominal bloating symptoms, the time of returning normal blood amylase and white blood cell count, and the occurrence of adverse reactions Happening. Results: In the control group of patients, the effective treatment of 35 patients, the total effective rate was 72.9%. In the experimental group of patients, the effective treatment of 45 patients, the total effective rate was 93.8%. The total effective rate of treatment in experimental group was significantly higher than that of control group, and the difference between the two groups was significant (p <0.05). ② In the experimental group, the symptoms of abdominal pain and abdominal distension disappeared, the time of returning blood serum amylase and white blood cell count to normal was significantly shorter than that of the control group, and the difference between the two groups was significant (p <0.05). ③ After treatment, the levels of serum IL-8 and TNF-α in both groups were significantly lower than those before treatment, and the decrease in the experimental group was significantly greater than that in the control group (p <0.05). ④ During the treatment, no serious adverse reactions occurred in both groups. Conclusion: The combined application of somatostatin and pantoprazole has the advantages of good curative effect, short course of treatment and low incidence of adverse reactions in the treatment of acute severe pancreatitis. It can be used as the first choice for clinical treatment of acute severe pancreatitis.