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目的研究急性高脂血症胰腺炎患者行低分子肝素和胰岛素与血浆置换联合治疗对症状改善、APACHEⅡ和炎症因子的影响。方法选取2013年5月至2016年5月诊治急性高脂血症胰腺炎82例患者资料予以回顾性分析,按照临床所用不同治疗方案分成两组,将行单纯低分子肝素治疗35例患者作为对照组,将行胰岛素与血浆置换联合治疗47例患者作为观察组,对两组症状改善、APACHEⅡ、Balthazar CT评分和炎症因子情况进行对比。结果治疗后观察组胃肠功能的恢复时间为(4.08±0.05)d,腹膜炎消失时间为(10.10±5.02)d,及腹痛症状缓解时间为(4.06±1.06)d,均短于对照组[(6.50±2.20)d、(13.96±7.10)d、(9.56±2.12)d,P均<0.01];两组治疗后APACHEⅡ、Balthazar CT评分和TNF-α、IL-6水平均明显改善,且治疗组治疗后优于对照组(P<0.05,P<0.01)。结论急性高脂血症胰腺炎患者行胰岛素与血浆置换联合治疗能够改善临床症状和炎症因子水平,并缓解患者病情。
Objective To study the effects of low molecular weight heparin, insulin and plasma exchange on the improvement of symptoms, APACHEⅡ and inflammatory cytokines in patients with acute hyperlipidemic pancreatitis. Methods From May 2013 to May 2016, 82 patients with acute hyperlipidemic pancreatitis were retrospectively analyzed. According to the different clinical treatment plans, the patients were divided into two groups. 35 patients treated with simple low molecular weight heparin as control Group, the combination of insulin and plasma exchange treatment of 47 patients as the observation group, two groups of symptoms, APACHE Ⅱ, Balthazar CT score and inflammatory factors were compared. Results The recovery time of gastrointestinal function in observation group was (4.08 ± 0.05) d after treatment, (10.10 ± 5.02) days in peritonitis and 4.06 ± 1.06 days in abdominal pain were shorter than those in control group [( 6.50 ± 2.20) d, (13.96 ± 7.10) d, (9.56 ± 2.12) d, P <0.01 respectively. After treatment, APACHEⅡ, Balthazar CT score and TNF-α and IL-6 levels were significantly improved The treatment group was better than the control group (P <0.05, P <0.01). Conclusions Combined treatment of insulin and plasma exchange in patients with acute hyperlipidemic pancreatitis can improve clinical symptoms and inflammatory cytokines and alleviate the patient’s condition.