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目的:探讨重症急性胰腺炎(SAP)区域动脉灌注(RAI)序贯治疗的可行性及药物组合方案。方法:回顾性分析45例采用早期RAI治疗SAP患者的临床资料。结果:全组均使用的药物包括:⑴肝素生理盐水(25 U/mL,并以其作为作溶剂);⑵5-FU(第1周,250 mg/12 h,共7 d);⑶生长抑素或其类似物(0.4 mg/24 h善宁或6 mg生长抑素,共2周左右);⑷抗生素(12例继发感染者持续使用;23例无继发感染者预防性使用2周)。选择使用的药物包括:⑴乌司他丁灌注(5例合并MODS者,10~20万U/12 h,共7 d);⑵前列腺素E1(4例微循环障碍者,10μg/12 h)。全组2例死亡,其余43例治愈。结论:RAI治疗SAP有效可行,灌注中应注意药物的选择及配伍。
Objective: To investigate the feasibility of sequential treatment of regional arterial infusion (RAI) in patients with severe acute pancreatitis (SAP) and its drug combination. Methods: A retrospective analysis of 45 cases of early RAI treated SAP patients with clinical data. Drugs used in the whole group included: (1) heparin normal saline (25 U / mL as solvent); ⑵5-FU (250 mg / 12 h for the first week) for 7 days; (0.4 mg / 24 h Shanning or 6 mg somatostatin, a total of 2 weeks); ⑷ antibiotics (12 cases of secondary infection continued use; 23 cases of secondary infection in patients with prophylactic use of two weeks ). Drugs of choice include: ⑴ Ulinastatin perfusion (5 patients with MODS, 10 to 200,000 U / 12 h for 7 days); ⑵ Prostaglandin E1 (4 patients with microcirculation, 10 μg / 12 h) . Two patients died in the whole group and the remaining 43 patients were cured. Conclusion: SAP is effective and feasible for the treatment of SAP. The perfusion should pay attention to the choice of drugs and compatibility.