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目的：探讨生长抑素联合乌司他丁治疗重症急性胰腺炎的临床疗效和安全性。方法：将2013 年6 月至2015 年6 月期间云南省第三人民医院消化内科收治的96 例重症急性胰腺炎患者，随机将其分成对照组和乌司他丁治疗组，每组各48 例患者，对照组除常规治疗外给予生长抑素持续静脉滴注，乌司他丁组给予生长抑素联合乌司他丁联合治疗。治疗结束后，比较两组患者治疗总有效率，血清学相关指标及临床指标改善情况，并发症发生情况。结果：乌司他丁治疗组患者治疗总有效率（79.2%）明显高于对照组患者（64.6%）（P ＜ 0.05）；乌司他丁治疗组患者腹痛缓解时间、胃肠减压时间、中转手术率、住院时间及病死率[（3.2± 0.5）d，（7.3± 2.2）d，4.2%，（15.8± 1.5）d，6.3%] 均明显低于对照组患者[（4.9± 0.6）d，（11.5± 3.1）d，10.4%，（24.7± 2.1）d，12.5%]（P均＜ 0.05）；乌司他丁治疗组患者治疗后血清淀粉酶、白细胞、C反应蛋白以及白细胞介素6 [（140.2± 49.1）U/L，（5.2± 1.0）× 109/L，（6.3± 3.4）mg/L，（24.3± 4.2）ng/L] 均明显低于对照组患者[（430.6± 60.2）U/L，（10.2± 2.2）× 109/L，（16.3± 5.2）mg/L，（40.3± 5.9） ng/L]（P 均＜0.05）；乌司他丁治疗组患者并发症ARDS、急性肾功能衰竭、休克发生率（14.6%，12.5%，25.0%）明显低于对照组患者（35.4%，22.9%，39.6%）（P 均＜ 0.05）。结论：生长抑素联合乌司他丁治疗重症急性胰腺炎疗效显著，能够明显改善患者的血清及临床指标，减少并发症的发生率，值得临床推广应用。

英文摘要:

Objective:To evaluate the clinical efficacy and safety of ulinastatin plus somatostatin for patients with severe acute pancreatitis (SAP).Methods:During June 2013 to June 2015 at the Third peoples' hospital of the Yunnan province, 96 SAP patients were randomly divided into control and observation groups (n=48 each). The control group received an injection of somatostatin while the observation group had a combination of ulinastatin and somatostatin. After treatment, clinical efficacy, serum indicators and their improvements and complications were compared for two groups.Results:The overall efficiency of observation group was significantly higher than that of control group (79.2%vs 64.6%, P＜0.05). And abdominal pain relief time, decompression time, surgical intervention rate, length of stay and mortality rate of observation group (3.2± 0.5 d, 7.3± 2.2 d, 4.2%, 15.8± 1.5 d, 6.3%) were significantly lower than those of control group (4.9± 0.6 d, 11.5± 3.1 d, 10.4%, 24.7± 2.1 d, 12.5%)( P＜0.05). After treatment, the levels of serum amylase, white blood cell (WBC), C-reactive protein (CRP) and interleukin 6 (IL-6) of observation group (140.2± 49.1 U/L, 5.2± 1.0× 109 /L, 6.3± 3.4 mg/L, 24.3± 4.2 ng/L) were significantly lower than those of control group (430.6± 60.2 U/L, 10.2± 2.2× 109 /L, 16.3± 5.2 mg/L, 40.3± 5.9 ng/L) (P＜0.05). The incidences of such complications as acute respiratory distress syndrome (ARDS), acute renal failure and shock of observation group (14.6%, 12.5%, 25.0%) were significantly lower than those of control group (35.4%, 22.9%, 39.6%) (P＜0.05).Conclusion:Ulinastatin plus somatostatin can significantly improve the serum and clinical parameters and reduce the incidence of complications in SAP patients, and it is worthy of wider popularization.

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