【摘要】 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。更多还原

【Abstract】 Objective: To study the feasibility of sequential regional intra-arterial infusion(RAI) and drug combination schemes in treatment of severe acute pancreatitis(SAP). Methods: The clinical data of 45 patients with SAP undergoing early RAI treatment were retrospectively analyzed. Results: The drugs used in all cases included: ⑴ Disebrin saline(25 U/mL,used as the infusion vehicle for all drugs);⑵ 5-FU(250 mg/12 h,used in the first week for 7 days);⑶ Somatostatin or its analogue(0.4 mg sandostatin or 6 mg somatostatin,daily,for about 2 weeks);⑷ Antibiotics(continuous infusion in 12 cases with secondary infection and prophylactic use for 2 weeks in 23 cases without secondary infection).The selectively used medications included:⑴ Ulinastatin(10 000-20 000 U/12 h,in 5 cases complicated with MODS);⑵ Prostaglandin E1(10 μg/12 h,in 4 cases who had microcirculatory disturbance).Of the whole group,2 cases died and 45 cases were cured. Conclusion: RAI is a feasible and effective modality for SAP patients,but care must be taken for drug selection and compatibility during infusion.更多还原