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Objective:To study the clinical effect of different doses of ulinastatin combined with glutamine in treatment of acute severe pancreatitis.Methods:70 patients with acute severe pancreatitis patients admitted in our hospital from Jan. 2017 to Oct. 2019 were enrolled. According to the different dosage of ulinastatin, these patients were divided into 200 000 IU ulinastatin combined with glutamine group (200 000 IU combination group) , 400 000 IU ulinastatin combined with glutamine group (400000 IU combination group) , and 600 000 IU ulinastatin combined with glutamine group (600 000 IU combination group) . The study compared the 1-week mortality rate, abdominal pain relief time, respiratory frequency and heart rate back to normal time, blood amylase, glucose, C-reactive protein, procalcitonin levels, and white blood cell (WBC) count among the different groups.Results:The mortality of 400 000 IU combined group and 600 000 IU combined group were 4.35% and 5.56% respectively, which were significantly lower than 31.58% and 35% of the control group and 200 000 IU combined group ( P< 0.05) . The time of abdominal pain relief, respiratory rate and heart rate returning to normal in the 400 000 IU combined group were (7.21±1.25) d, (8.54±1.83) d and (9.54±2.23) d respectively, and (7.52±1.83) d, (8.13±1.75) d and (9.37±2.31) d in the 600 000 IU combined group, which were significantly lower than (9.12±2.78) d, (9.85± 3.16) d and (10.86±2.68) d in the control group and (8.76±1.96) d, (8.76±1.96) d and (10.62±1.43) d in the 200 000 IU combined group ( P<0.05) , There was no significant difference between the control group and the 200 000 IU combination group ( P>0.05) . Compared with the control group, there were significant differences in blood glucose, CRP and leukocyte count in different doses of ulinastatin+ glutamine treatment group ( P<0.05) ; However, there was no significant difference in blood glucose and CRP levels between different doses of ulinastatin+ glutamine treatment group ( P>0.05) , but compared with 200 000 IU combination group and 400 000 IU combination group, the leukocyte level of 600 000 combination group was significantly higher ( P<0.05) . Conclusion:ulinastatin combined with glutamine can significantly improve the clinical prognosis of patients with severe acute pancreatitis, but the clinical effect varies with the dose of ulinastatin. Conclusion Ulinastatin combined with glutamine can significantly improve the clinical prognosis of patients with acute severe pancreatitis, but the clinical effect varies with the dose of ulinastatin.
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Objective:To explore the effect and nursing measures of parenteral nutrition support treatment and nasal jejunum nutrition support treatment in patients with acute severe pancreatitis.Method:85 cases of acute severe pancreatitis were divided into the study group and the control group.The patients in the control group were given routine parenteral nutrition support therapy and clinical nursing.The patients in the study group were treated with nasal jejunum tube for enteral nutrition support,and the corresponding clinical nursing intervention was given during the treatment.The clinical indexes of two groups were compared and analyzed.Result:Before treatment,there were no significant difference in serum CRP,ALB,TP levels between the two groups (P ＞ 0.05).After nutritional treatment and clinical nursing,the above indexes of the two groups were improved,but the indexes of the study group improved significantly more than the control group (P ＜ 0.05).The BMI index in the study group was not significantly different compared with the control group (P ＞ 0.05).In the study group,the first time of get out of bed,mechanical ventilation time,abdominal distension remission time,sserum amylase and urine amylase recovery time were significantly lower than those of the control group (P ＜ 0.05).The incidence of complications including abdominal distension,diarrhea,nausea and vomiting,upper gastrointestinal bleeding in the study group were significantly lower than those in the control group (P ＜ 0.05).Conclusion:nasal jejunum nutrition support treatment can not only play a vital role in treatment of acute severe pancreatitis patients with malnutrition,but also protect the patient gastrointestinal tract.The individualized nursing intervention can effectively reduce the incidence of complications and ensure the successful implementation of enteral nutrition.
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Objective To research the efficacy of alprostadil injection combined the octreotide for acute severe pancreatitis and influence on the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6,interleukin-18,occludin.Method 68 cases of patients with acute severe pancreatitis from September 2013 to February 2017 in our hospital,according to the treatment method group,34 cases in each group,control group treatmented by octreotide,the research group based on the control group treatmented by alprostadil injection,both groups was treated for five days.Clinical curative effect,alleviate clinical symptoms time,TNF-α,IL-6,IL-18,occludin,and adverse reactions occur was compared between two groups.Results The total effective rate of research group was higher than the control group(97.07％vs.79.41％,P<0.05).Bowel sounds,stomach ache,body temperature and serum amylase remission time of research group was shorter than control group(P<0.05).TNF-α,IL-6,IL-18 of research group was lower than the control group(P<0.05),the occludin of research group was higher than the control group(P<0.05).The adverse reactions was no differences between the two groups.Conclusion The exact effect of alprostadil injection combined the octreotide for acute severe pancreatitis,improve serum levels of TNF-α,IL-6,IL-18,occludin.
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OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with octreotide and ulinastatin in the treatment of acute severe pancreatitis.METHODS:A total of 150 patients with acute severe pancreatitis admitted to emergency department of our hospital during Jan.2012-Jan.2016 were divided into control group,drug control group and observation group according to therapy method,with 50 cases in each group.All patients were treated with fasting,gastrointestinal decompression time,antibiotics,blood purification and other conventional treatment.Control group additionally received Cctreotide acetate injection 0.1 mg intravenously,tid,on the basis of conventional treatment.Drug control group additionally received Ulinastatin for injection 100 000 U added into 10％ Glucose injection 250 mL,ivgtt,bid,on the basis of control group.Observation group additionally received Xuebijing injection 100 mL added into 10％ Glucose injection 100 mL,ivgtt,bid,on the basis of drug control group.Three groups were treated for 10 days.The clinical indexes as fotal response rates,gastrointestinal decompression time,abdominal pain relief time,length of stay were observed in 3 groups.Related serum indexes (AMY,WBC,IL-6,CRP,TNF-α) before and after treatment and the occurrence of compliance during treatment were compared among 3 groups.RESULTS:The total response rate of observation group was 90.0％,which was significantly higher than 72.0％ of drug control group and 52.0％ of control group,with statistical significance (P＜0.05).The gastrointestinal decompression time,abdominal pain relief time and length of stay in observation group were significantly shorter than drug control group and control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the serum levels of AMY,WBC,IL-6,CRP or TNF-α among 3 groups (P＞0.05).After treatment,above serum indexes of 3 groups were decreased significantly,and observation group was significantly lower than the drug control group and control group,with statistical significance (P＜0.05).The incidence of ARDS,shock and acute renal failure in observation group were significantly lower than drug control group and control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of sepsis,abdominal abscess or MODS among 3 groups (P＞0.05).CONCLUSIONS:Xuebijing injection combined with octreotide and ulinastatin show significant therapeutic efficacy for acute severe pancreatitis,can effectively control inflammation progress,improve clinical symptoms and promote disease recovery with good safety.
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Objective:To observe the clinical effect of ulinastatin combined with somatostatin in the treatment of acute severe pan-creatitis. Methods:Totally 130 cases of severe acute pancreatitis patients were randomly divided into two groups with 65 cases in each. The control group was given the routine treatment and 3mg somatostatin in 250ml sodium chloride injections, ivd, bid, and the treatment group was given 10ku ulinastatin in 250ml sodium chloride injections additionally, ivd, bid. After the 10-day treatment, the clinical symptom disappearance time, the recovery time of respiratory and heart rate, length of stay, blood and urine amylase, and clin-ical total effective rate were compared between the two groups. Results:The symptom disappearance time, recovery time of respiratory and heart rate and length of stay in the treatment group were all shorter than those in the control group (P0. 05). The total effective rate of the treatment group was 95. 38%, while that of the control group was 73. 84% with significant difference (P<0. 05). Conclusion:The application of ulinastatin in the treatment of severe acute pancreatitis shows obviously curative effect, which can effectively improve the clinical symptoms and shorten the course of disease, and is valuable in clinical use.
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Objective To investigate the effects of early parenteral feeding with glutamine on nitrogen balance and clinieal prognosis in Pationts with acute severe pancreatitis.Methods120 acute severe pancreatitis patients with Ranson scale≥3 were studied.Patients were randomized to receive either an early parenteral diet(control group,n=60) or the same formula with glutamine added(study group,n=60).The diets were isocaloric and isonitrogenous [35 kcal ? kg-1 ? day-1 and 1.5g of protein/(kg-1 ? d)].Main outcome measures were the APACHE-Ⅱ scale,incidence of infection,the length of stay in the intensive care unit and the number of days requiring mechanical ventilation,and monitor the nitrogen balance.ResultsThe two groups were homogeneous in gender,age,nutritional status and admission.There was no mortality during the study period.The two group have no statistic defference in nitrogen balance of 4.7 day.The median(range) number of infections per patient was significantly greater(P
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Objective To investigate the effect of interventional therapy for acute severe pancreatitis.Methods A total of 70 patients with acute severe pancreatitis were randomly divided into Control(common medication) and Interventional Therapy groups(common medication plus interventional therapy) with 35 cases in each.The curative effect was compared between the two groups.Results Compared with the Control Group,the patients in the Interventional Therapy Group had a significantly lower mortality [25.7%(9/35) vs 5.7%(2/35);?2=5.285,P=0.022],lower incidence of ARDS [37.1%(13/35) vs 14.3%(5/35);?2=4.786,P=0.029],decreased incidence of pancreatic encephalopathy[34.3%(12/35) vs 11.4%(4/35);?2=5.185,P=0.023],shorter recovery time of serum amylase[(7.6?2.1) d vs(3.4?1.5) d;t=-9.628,P=0.000],and shorter hospital stay[(34.0?6.4) d vs.(23.5?8.9) d;t=-5.667,P=0.000].In the Interventional Group,the symptoms and signs disappeared at(10.0?2.4)d after the treatment,which was significantly earlier than that in the Control Group(18.0?2.6)d(t=-13.376,P=0.000).Conclusions Interventional therapy can effectively control acute severe pancreatitis and shorten the course of the disease.
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Objective To explore the therapeutic effects of early mechanical ventilation and bedside h emafiltration in acute severe pancreatitis with acute lung injury Metho ds17 patients of acute severe pancreatitis with acute lung injury were ventilated (V T 8 ml/kg,PEEP 5～10 cm H 2 O) within 24 hrs after diagn osed Meanwhile bedside hemafiltration was performed six hours per day for 5 da ys The oxygenation and hemodynamics,function of heart,liver and kidney were m onitored ResultsCompared with control group,PaO 2 and P aO 2 /FiO 2 were increased markedly (P
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Objective: To study the clinical effect of enteral nutrition(EN) support for acute severe pancreatitis(ASP) by comparing the curative effect of EN and parenteral nutrition(PN) support for ASP.Methods: 65 cases of ASP were randomized into EN group and PN group to observe the nutritional status,immnological index,infectious rate,mortality,hospitalization duration and costs of the two groups.Results: After nutritional support,serum albumin,pro-albumin and siderin in both groups obviously increased and blood glucose and amylase significantly decreased(P