CAJ | 학술논문

目的探讨小剂量低分子肝素抗凝治疗对急性胰腺炎(AP)患者的影响.方法收集2002年至2008年住院治疗的98例AP患者,按数字表法随机分为抗凝治疗组(40例)和常规治疗对照组(58例).治疗组包括重症急性胰腺炎(SAP)15例和轻症急性胰腺炎(MAP)25例;对照组包括SAP19例和MAP 39例.对照组常规治疗,治疗组在常规治疗的基础上给予低分子肝素3 000 U皮下注射,每12 h一次,持续2周.观察各组患者治疗前后APACHEⅡ评分、并发症发生率、病死率和平均住院天数,以及治疗组的出凝血指标变化.结果治疗组中SAP患者治疗后7 d的APACHEⅡ评分、并发症发生率、病死率和住院天数分别为9.9±4.9、20%、13.3%和(20.6±10.4)d;对照组SAP患者分别为12.2±4.8、42.1%、47.4%和(28.2±12.5)d,两组差异均有统计学意义(P<0.05).而治疗组和对照组的MAP患者之间上述指标的差异均无统计学意义.治疗组应用低分子肝素前后出凝血指标变化也无统计学意义.结论小剂量低分子肝素能降低sAP患者并发症发生率和病死率,缩短住院时间,不引起出血并发症,建议早期应用.
목적 탐토소제량저분자간소항응치료대급성이선염(AP)환자적영향.방법 수집2002년지2008년주원치료적98례AP환자,안수자표법수궤분위항응치료조(40례)화상규치료대조조(58례).치료조포괄중증급성이선염(SAP)15례화경증급성이선염(MAP)25례;대조조포괄SAP19례화MAP 39례.대조조상규치료,치료조재상규치료적기출상급여저분자간소3 000 U피하주사,매12 h일차,지속2주.관찰각조환자치료전후APACHEⅡ평분、병발증발생솔、병사솔화평균주원천수,이급치료조적출응혈지표변화.결과 치료조중SAP환자치료후7 d적APACHEⅡ평분、병발증발생솔、병사솔화주원천수분별위9.9±4.9、20%、13.3%화(20.6±10.4)d;대조조SAP환자분별위12.2±4.8、42.1%、47.4%화(28.2±12.5)d,량조차이균유통계학의의(P<0.05).이치료조화대조조적MAP환자지간상술지표적차이균무통계학의의.치료조응용저분자간소전후출응혈지표변화야무통계학의의.결론 소제량저분자간소능강저sAP환자병발증발생솔화병사솔,축단주원시간,불인기출혈병발증,건의조기응용.
Objective To investigate the effect of low dose low molecular weight heparin (LMWH) on acute pancreatitis (AP). Methods 98 AP patients who were admitted in our hospital from 2002 to 2008 were randomly divided into anticoagulant therapy group (n = 40) and control group (n = 58). Anticoagulant therapy group consisted of 15 cases of severe acute pancreatitis (SAP) and 25 cases of mild acute pancreatitis (MAP) ; while there were 19 cases of SAP and 39 cases of MAP in control group. The patients of control group received conventional treatment, and conventional therapy together with 3 000 U LMWH subcutaneous injection every 12 hours were used in anticoagulant therapy group for two weeks. The changes of APACHE II score, complication rate, mortality and length of hospital stay were observed and the coagulation changes before and after anticoagulant therapy were documented. Results 7 days later, the APACHE II score, complication rate, mortality and length of hospital stay of SAP patients in the anticoagulant therapy group were 9. 9 ±4. 9, 20% , 13.3% , (20.6 ±10.4)d, respectively; while they were 12. 2 ±4.8, 42. 1%, 47.4%, (28. 2 ± 12. 5) d, respectively, in the control group, and the difference was statistically significant (P < 0. 05). The corresponding values were not statistically significantly different among MAP patients in the two groups. The coagulation after treatment in anticoagulant therapy group was not statistically different with that before treatment. Conclusions Low dose LMWH could reduce the rate of complication rate, mortality and decrease the length of hospital stay, without complication of hemorrhage, which should be recommended in the early phase of SAP.