黄敬恩+甘小海

[摘要]目的 研究醋酸奧曲肽注射液联合奥美拉唑钠注射液治疗急性胰腺炎的效果。方法 将我科2013年5月～2016年9月收治的46例急性胰腺炎患者随机分为观察组和对照组，每组23例。在常规治疗的基础上，对照组患者给予奥美拉唑钠注射液静脉滴注治疗；观察组患者在对照组患者基础上给予醋酸奥曲肽注射液持续静脉泵注治疗。比较两组患者的临床症状及体征改善时间、实验室检查指标恢复正常水平时间；观察两组患者治疗前后的血清C反应蛋白（CRP）及淀粉酶水平变化情况，比较两组患者的治疗效果及并发症发生率。结果 观察组患者主要临床症状及体征的改善时间和实验室检查指标恢复正常水平的时间均较对照组显著缩短（P<0.01）。两组患者治疗后的血清CRP及淀粉酶水平均较治疗前显著降低（P<0.01），且治疗后，观察组患者的血清CRP及淀粉酶水平显著低于对照组（P<0.01）。观察组患者治疗总有效率为87.0%，显著高于对照组的60.9%（P<0.05）。观察组患者的并发症发生率为8.7%，显著低于对照组的34.8%（P<0.05）。结论 醋酸奥曲肽注射液联合奥美拉唑钠注射液可显著提高治疗效果，促进症状改善和机体恢复，减轻炎症状态及胰腺损伤。

[关键词]奥曲肽；奥美拉唑钠；急性胰腺炎；C反应蛋白；淀粉酶

[中图分类号] R657.5+1 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0027-03

[Abstract]Objective To study the effect of Octreotide Acetate Injection combined with Omeprazole Sodium Injection in the treatment of acute pancreatitis.Methods 46 patients with acute pancreatitis admitted into our department from May 2013 to September 2016 were randomly divided into the observation group （n=23） and the control group （n=23）.On the basis of routine treatment，the patients in the control group were treated with intravenous drip of Omeprazole Sodium Injection.Patients in the observation group were given continuous intravenous infusion of Octreotide Acetate Injection on the basis of the control group.The remission time of clinical symptoms and physical signs，and the time of laboratory test indicators returning to normal level were compared between two groups.The change of the level of serum C-reactive protein （CRP） and amylase were observed before and after treatment in both groups.The clinical therapeutic effect and incidence rate of complications were compared between the two groups.Results The time of the improvement of clinical symptoms and physical signs and the time of laboratory test indicators returning to normal level in the observation group were significantly shorter than those in the control group （P<0.01）；the level of serum CRP and amylase in the two groups after treatment were significantly lower than those before treatment （P<0.01），and the level of serum CRP and amylase in the observation group were significantly lower than those in the control group （P<0.01）；the total effective rate was 87.0% in the observation group，and it was significantly higher than that of 60.9% in the control group （P<0.05）.The incidence rate of complications in the observation group was 8.7%，and it was significantly lower than that of 34.8% in the control group （P<0.05）.Conclusion Octreotide Acetate Injection combined with Omeprazole Sodium Injection can significantly improve the therapeutic effect of acute pancreatitis，promote the improvement of symptoms and recovery of the body，and reduce the inflammatory state and pancreatic injury.

[Key words]Octreotide Acetate；Omeprazole Sodium；Acute pancreatitis；C-reactive protein；Amylase

急性胰腺炎是由胆道感染、过量饮酒、暴饮暴食等因素导致胰酶激活破坏胰腺组织所引起的局部炎症反应，以腹痛为突出表现，是临床常见的消化系统疾病[1]。其发病急、进展快，以轻症多见，但治疗不及时可引起感染、腹膜炎、休克等，严重者可导致多器官功能障碍甚至死亡[2]。奥曲肽是一种人工合成的生长抑素类似物，可抑制细胞因子和炎性物质的生成及释放，对胰腺细胞具有一定的保护作用，可用于治疗急性胰腺炎[3]。本研究旨在探讨醋酸奥曲肽注射液和奥美拉唑钠注射液联合治疗急性胰腺炎的效果，现报道如下。……