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目的评价小剂量普通肝素与乌司他丁联用治疗重症急性胰腺炎(SAP)的疗效。方法将攀钢总医院2004年1月至2008年1月采用小剂量普通肝素联合乌司他丁与传统方法治疗SAP的临床资料分为治疗组和对照组,比较两组入院后第1、3、5天APACHEⅡ评分、血清淀粉酶、血尿素氮(BUN)、血钙、血糖、白细胞计数的变化以及腹痛、腹胀等主要临床症状改善情况和住院天数、并发症发生率及死亡率。结果治疗组并发症发生率为10.87%,对照组为21.43%,两组第3、5天APACHEⅡ评分比较差异有统计学意义(P<0.05),治疗组血清淀粉酶、血BUN、血糖和白细胞计数降低及血钙升高较对照组更为明显,两组差异有统计学意义(P<0.01),治疗组腹部症状缓解时间较对照组短,两者差异有统计学意义(P<0.05)。结论小剂量普通肝素和乌司他丁联用可使SAP严重程度迅速降低,腹部症状迅速缓解,减少并发症发生率及死亡率,缩短住院时间,降低住院费用,且疗效较为显著。
Objective To evaluate the efficacy of low-dose unfractionated heparin combined with ulinastatin in the treatment of severe acute pancreatitis (SAP). Methods Panzhihua General Hospital from January 2004 to January 2008 using low-dose unfractionated heparin combined with ulinastatin and traditional methods of treatment of SAP clinical data were divided into treatment group and control group, compared two groups after admission 1,3 , 5-day APACHEⅡscore, serum amylase, blood urea nitrogen (BUN), blood calcium, blood glucose, leukocyte count changes and abdominal pain, abdominal distension and other major clinical symptoms and hospital stay, complication rate and mortality. Results The incidence of complications was 10.87% in the treatment group and 21.43% in the control group. There was significant difference in the APACHEⅡscore between the two groups on the 3rd and 5th days (P <0.05). Serum amylase, blood BUN, blood glucose and white blood cells (P <0.01). The time to relieve the abdominal symptoms in the treatment group was shorter than that in the control group (P <0.05), and the difference between the two groups was statistically significant (P0.05) . Conclusions The combination of low-dose unfractionated heparin and ulinastatin can rapidly reduce the severity of SAP, rapidly relieve the symptoms of the abdomen, reduce the complication rate and mortality, shorten the length of hospital stay and reduce the cost of hospitalization.