胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的评价

doi:10.3969/j.issn.1000-8535.2022.04.019

广州医药 ›› 2022, Vol. 53 ›› Issue (4): 83-88.DOI: 10.3969/j.issn.1000-8535.2022.04.019

胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的评价

廖碧玲¹, 巫泓生², 张升敏², 曹天生²

1 广州市花都区人民医院手术麻醉科(广州510800)
2 广州市花都区人民医院肝胆胰外科(广州510800)

收稿日期:2021-10-02 出版日期:2022-07-20 发布日期:2022-08-03
通讯作者: 曹天生,E-mail:caotiansheng2088@sina.com
基金资助:
广州市花都区医疗卫生一般科研专项(21-HDWS-033);广州市花都区人民医院院内科研基金项目(2020A01)

Evaluation of curative effect of insulin combined with ulinastatin on hyperlipidemic severe pancreatitis

LIAO Biling¹, WU Hongsheng², ZHANG Shengmin², CAO Tiansheng²

1 Surgical Anesthesia Department, People's Hospital of Huadu Distict, Guangzhou 510800,China
2 Hepatobiliary Pancreatic Surgery Department,People's Hospital of Huadu Distict, Guangzhou 510800,China

Received:2021-10-02 Online:2022-07-20 Published:2022-08-03

摘要/Abstract

摘要： 目的探讨胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的临床疗效。方法研究资料来自广州市花都区人民医院肝胆胰外科自2018年—2020年收治的72例高脂血症性重症胰腺炎患者资料,所有患者按照不同治疗方案随机分为3组,每组各24例。对照组采用急性胰腺炎常规治疗(即生长抑素+液体疗法);乌司他丁组则于常规组上联用乌司他丁;而研究组在常规及联合乌司他丁治疗基础上加用胰岛素强化治疗,比较3组患者腹痛及胃肠功能恢复的时间、甘油三酯下降的水平,治疗前、治疗后第3天、7天的APACHE Ⅱ评分的变化情况。结果研究组患者腹痛症状缓解及胃肠功能恢复时间均较对照组明显缩短、腹痛症状缓解时间较乌司他丁组缩短,且研究组甘油三酯下降水平较对照组和乌司他丁组快,而研究组第3天和第7天的APACHE-Ⅱ评分较常规组及乌司他丁组低,以上差别均有统计学意义(P<0.05)。结论胰岛素联合乌司他丁可明显改善高脂血症合并重症急性胰腺炎腹部症状、缩短胃肠功能恢复时间、迅速降低血清甘油三酯水平,对患者近期疗效确切。

关键词: 急性重症胰腺炎, 高脂血症, 胰岛素, 乌司他丁, 联合治疗

Abstract: Objective To explore curative effect of insulin combined with ulinastatin in therapy of severe hyperlipidemic pancreatitis. Methods A total of 72 patients with hyperlipidemia complicated with severe acute pancreatitis were randomly divided into three groups according to different treatment plans, 24 cases in each group. The regular treatment of acute pancreatitis (somatostatin+liquid therapy) was carried out in control group. Base on the regular treatment of acute pancreatitis, ulinastatin was added in ulinastatin group. Base on the treatment of ulinastatin group, insulin was added in study group, and the time of abdominal pain and gastrointestinal function recovery, glycerin level and the APACHE Ⅱ score before and after treatment among three groups were compared. Results Compared with the control group and ulinastatin group, the time of abdominal pain relief and gastrointestinal function recovery in the study group were significantly shorter, the time of triglycerides level back to normal in the study group was shorter than the other two groups, while at the third and seventh day, the APACHE Ⅱ score of the study group was lower than that of other two groups, with statistical significance (P<0.05). Conclusions Insulin combined with ulinastatin could significantly improve abdominal symptoms of hyperlipidemia complicated with severe acute pancreatitis, promote the recovery of gastrointestinal function, and rapidly reduce the level of serum triglyceride.

Key words: severe acute pancreatitis, hyperlipidemic, insulin, ulinastatin, combination therapy

廖碧玲, 巫泓生, 张升敏, 曹天生. 胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的评价[J]. 广州医药, 2022, 53(4): 83-88.

LIAO Biling, WU Hongsheng, ZHANG Shengmin, CAO Tiansheng. Evaluation of curative effect of insulin combined with ulinastatin on hyperlipidemic severe pancreatitis[J]. Guangzhou Medical Journal, 2022, 53(4): 83-88.

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胰岛素联合乌司他丁在高脂血症性重症胰腺炎中的评价

Evaluation of curative effect of insulin combined with ulinastatin on hyperlipidemic severe pancreatitis

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