【摘要】 目的研究谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎的临床疗效。方法急性重症胰腺炎患者80例随机分为对照组和治疗组,每组40例,对照组给予乌司他丁、亚胺培南治疗,治疗组在对照组基础上给予谷氨酰胺治疗。疗程均为2周。观察2组临床疗效、症状改善程度、生化指标、血清降钙素原(PCT)、尿中胰蛋白酶原激活肽(TAP)、APACHEⅡ评分、CT评分、并发症发生情况、中转手术及死亡情况。结果治疗组总有效率较对照组明显提高,差异有统计学意义(P <0. 05)。治疗组首次排便时间、腹痛缓解时间、腹胀缓解时间、肠鸣音恢复时间较对照组明显缩短,差异有统计学意义(P <0. 05)。与治疗前比较,2组治疗后血淀粉酶、血肌酐、尿淀粉酶、尿素氮、PCT、TAP水平、APACHEⅡ评分、CT评分均显著低于治疗前,且治疗组各指标低于对照组(P <0. 05)。治疗组并发症发生率、中转手术率、病死率较对照组明显降低,差异有统计学意义(P <0. 05)。结论谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎疗效确切,能够有效促进胃肠功能恢复,降低并发症发生率,改善患者预后,值得临床推广应用。更多还原

【Abstract】 Objective To observe the therapeutic effects of glutamine combined with ulinastatin and imipenem on severe acute pancreatitis. Methods A total of 80 patients with severe acute pancreatitis were randomly divided into control group(n = 40) and treatment group(n = 40). The patients in control group were treated by ulinastatin and imipenem,however,the patients in treatment group,on the3 basis of control group,were treated by glutamine,with a treatment course of 2 weeks for both groups. After treatment,the clinical curative effects,,the improvement extent of symptoms,biochemical indexes,PCT,TAP,APACHEⅡ and CT scores,complications,conversion rate of operation and mortality rate were observed and compared between the two groups. Results The total effective rate in treatment group was significantly higher than that in control group(P < 0. 05). The first defecation time,recovery time of abdominal pain and abdominal distention,bowel sounds recovery time in treatment group were significantly shorter than those in control group(P < 0. 05). As compared with those before treatment,the levels of amylase in urine and blood,serum creatinine,blood urea nitrogen,PCT,TAP,APACHEⅡ and CT scores were significantly decreased in both groups,moreover,the above indexes in treatment group were significantly lower than those in the control group(P < 0. 05). In addition the incidence of complications,conversion rate of operation and mortality rate in treatment group were significantly lower than those in control group(P < 0. 05). Conclusion The glutamine combined with ulinastatin and imipenem has obvious therapeutic effects on severe acute pancreatitis,which can effectively promote recovery of gastrointestinal function,reduce the incidence of infection and other complications,and improve the prognosis of patients,therefore,which is worthy of application and promotion in clinical practice.更多还原