摘要
目的探讨乌司他丁(UTI)对急性有机磷农药中毒(AOPP)并发急性胰腺炎(AP)酶学的影响。方法回顾性分析聊城市人民医院急诊科2016年1月至2017年1月收治的55例确诊AOPP并发AP患者,其中男性24例,女性31例;年龄19~70岁[(47.3±10.7)岁]。将患者按随机数字表方法随机分为UTI干预组(25例)和对照组(30例)。对照组采用常规治疗方案,UTI干预组在常规治疗的基础上加用UTI进行干预(UTI 10万U+5%葡萄糖注射液250 m L,静脉滴注,q 8 h)。比较两组患者腹痛及腹部压痛缓解时间;观察两组患者治疗前和治疗第2、3、5、7天全血胆碱酯酶(Ach E)、血清淀粉酶、脂肪酶和尿淀粉酶变化,并比较两组血清及尿淀粉酶恢复正常范围时间、住院时间及总治疗有效率。结果 UTI干预组患者腹痛缓解时间[(35.46±6.58)h]、腹部压痛缓解时间[(48.26±8.46)h]均短于对照组[(48.25±8.31)h、(68.54±9.93)h](P均<0.05);Ach E在第5、7天UTI干预组高于对照组(P<0.05);血淀粉酶、脂肪酶在入院后第3、5、7天UTI干预组均低于对照组(P均<0.05);尿淀粉酶于入院后第5、7天低于对照组(P均<0.05);UTI干预组患者住院时间[(8.13±1.23)d]、血清和尿淀粉酶恢复正常范围时间[(6.68±1.03)d与(7.23.6±1.15)d]均短于对照组(13.25±2.11)d、(9.07±1.45)d与(11.35±2.05)d],差异均有统计学意义(P均<0.05);UTI干预组治疗总有效率[95.6%(24/25)]高于对照组[80.9%(23/30)](P<0.05)。结论 UTI能通过促进Ach E恢复,抑制血清及尿淀粉酶和脂肪酶释放,起到加速治疗AOPP并发AP的作用,临床疗效显著。
Objective To evaluate the effects of ulinastatin on the enzymology of acute pancreatitis induced by acute organophosphorus poisoning. Methods Retrospective analysis was made to 55 cases of AOPP patients with AP admitted to the emergency department of Liaocheng People's Hospital from January2016 to January 2017,including 24 males,31 females,aged from 19 to 70 years old[( 47. 3 + 10. 7) years old]. Patients were randomly divided into UTI intervention group( n = 25) and control group( n = 30). The control group was treated with conventional therapy. The UTI intervention group was treated with UTI( 100,000 U UTI + 5% glucose injection 250 m L,intravenous infusion,q 8 h). The degree and relief time of abdominal pain in two groups of patients were compared and the changes of blood cholinesterase( Ach E),serum amylase,urine amylase and lipase before and after 2,3,5,7 days treatment in two groups were also observed. The time of serum and urine levels of amylase returned to normal,hospitalization time and total treatment efficiency were compared. Results The abdominal pain relief time [( 35. 46 ± 6. 58) h ],abdominal tenderness alleviate [( 48. 26 ± 8. 46) h] time in the UTI intervention group were shorter than those in the control group [( 48. 25 ± 8. 31) h,( 68. 54 ± 9. 93) h]( P < 0. 05). The levels of Ach E in the UTI intervention group in 5,7 day was higher than that in the control group( P < 0. 05). The levels of serumamylase and lipase in the UTI intervention group in the 3,5 and 7 days were lower than those in the control group( P < 0. 05). The levels of urine amylase in the UTI intervention group in 5,7 day was lower than those in the control group( P < 0. 05). UTI intervention group The hospitalized time [( 8. 13 + 1. 23) d],serum and urine amylase returned to normal range of time [( 6. 68 ± 1. 03) d and( 7. 23. 6 ± 1. 15) d] in UTI group are shorter than those in the control group [( 13. 25 ± 2. 11) d、( 9. 07 ± 1. 45) d 与( 11. 35 ±2. 05) d],and the difference is statistically significant( P < 0. 05). The total effective rate in the UTI intervention group was [95. 6%( 24/25) ] was significantly higher than that in the control group [80. 9%,( 23/30) ]( P < 0. 05). Conclusion UTI can promote Ach E recovery,inhibit the release of serum and urine amylase and lipase and play an positive role in the treatment of AOPP patients with AP. The clinical effect is significant.
出处
《中华卫生应急电子杂志》
2017年第6期334-338,共5页
Chinese Journal of Hygiene Rescue(Electronic Edition)
关键词
急性有机磷农药中毒
急性胰腺炎
乌司他丁
Acute organuphasphorus pesticide poisoning
Acute pancreatitis
Ulinastatin
