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目的分析不同剂量生长抑素治疗老年重症急性胰腺炎(SAP)的临床疗效。方法选取我科2010年1月至2015年1月老年SAP患者共80例,随机分为强化组和对照组,每组40例。分别予以发病后24 h内生长抑素12mg/d和6 mg/d静脉滴注,疗程7 d。对比两组患者治疗前后的血清学指标、胃肠动力恢复情况、并发症和死亡发生率。结果两组患者治疗后1 d、3 d CRP水平显著上升,治疗后7 d回落;强化组治疗后1 d、3 d、7 d CRP水平与对照组比较差异有统计学意义(P<0.05)。两组患者治疗7 d后的IL-6、IL-8和TNF-ɑ水平与治疗前比较差异有统计学意义,强化组治疗7 d后的IL-6、IL-8和TNF-ɑ水平与对照组比较差异有统计学意义(P<0.05)。强化组的排气恢复、排便恢复、肠鸣音恢复、腹痛消失和腹胀消失时间与对照组比较差异有统计学意义(P<0.05)。强化组并发症发生率(10.00%)与对照组(37.50%)比较差异有统计学意义(P<0.05),强化组死亡率为5.00%,和对照组7.50%比较差异无统计学意义(P<0.05)。结论采用12 mg/d生长抑素治疗老年SAP,较6 mg/d可有效改善患者炎症水平,促进胃肠道动力恢复,降低并发症发生率。
Objective To analyze the clinical effects of different doses of somatostatin in the treatment of senile severe acute pancreatitis (SAP). Methods A total of 80 elderly SAP patients from January 2010 to January 2015 in our department were selected and randomly divided into the intensive group and the control group, 40 cases in each group. Respectively, within 24 h after onset of somatostatin 12mg / d and 6 mg / d intravenous infusion, treatment of 7 d. Serum parameters, gastrointestinal motility recovery, complications and death rate were compared between the two groups before and after treatment. Results The levels of CRP on the 1st and 3rd day after treatment in both groups increased significantly and dropped on the 7th day after treatment. The levels of CRP on the 1st, 3rd, and 7th days after treatment in the two groups were significantly different from those in the control group (P <0.05) . The levels of IL-6, IL-8 and TNF-ɑ in the two groups after 7 days of treatment were significantly different from those before treatment, and the levels of IL-6, IL-8 and TNF- The difference between the control group was statistically significant (P <0.05). There was significant difference between the two groups (P <0.05). The recovery time, defecation recovery, bowel sounds recovery, disappearance of abdominal pain and disappearance of abdominal distension in the intensive group were significantly different from those in the control group (P <0.05). The complication rate in intensive group (10.00%) was significantly lower than that in control group (37.50%) (P <0.05), and the mortality in intensive group was 5.00%, which was not significantly different from that in control group (P> 0.05) <0.05). Conclusions The use of 12 mg / d somatostatin in the treatment of elderly SAP, compared with 6 mg / d, can effectively improve the level of inflammation in patients with gastrointestinal motility and reduce the incidence of complications.