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The Vital Effects of Ulinastatin and Octreotide for Patients with Severe Acute Pancreatitis

Author: NiuZuoFeng
Tutor: ZhaoHaoLiang
School: Shanxi Medical
Course: Surgery
Keywords: Severe Acute Pancreatitis Ulinastatin Octreotide Therapeutic Effectiveness
CLC: R576
Type: Master's thesis
Year: 2013
Downloads: 9
Quote: 0
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Abstract


[Background]Acute pancreatitis is acute chemical inflammation which caused by pancreatic tissue own digestion of pancreatic enzyme activation, Sometimes it also damage other organs and cause worse situation. The percent of severe acute pancreatitis (severe acute pancreatitis, SAP) accounts for20%-30%of acute pancreatitis (acute pancreatitis, AP). Patients with SAP have worse situation, much complications and poorer prognosis. Abnormal activation of pancreatic enzymes in pancreas injured itself. Meanwhile, it activates mononuclear phagocyte system to synthetize and release inflammatory mediators like cytokines, thus lead to systemic inflammatory response syndrome. Most researches domestic and overseas advocate early nonoperative treatment. Octreotide is an artificially synthesized octapeptide analogue of natural somatostatin, it has conviennient use and long half-life period and many physiological activities. It can restrain growth hormone, thyrotropic hormone, gastric acid, pancreatic enzymes glucagon, insulin etc. UTI is trypsin inhibitor which derived from human urine. It can restrain carbohydrate lipid hydrolysis enzymes such as trypsase, elastinase, proteolytic enzyme, hyaluronidase amylase and lipase. It can stabilize lysosomal membrane, can regulate vascular endothelial cell function, improve circulation and relieve damage of tissue through inhibiting lysosomal enzyme and myocardial depressant factor release. In those ways above, it can alleviate autodigestion and endotoxin absorption. It places an important role in the occurrence and exacerbation of AP. Then this can reduce the local and remote organ damage. Studies have pointed out that the effect of octretide and UTI combination is good. But there are others that show no significant Collaborative treatment effect of the combination.[Objective]We discuss the effect of combination of Ulinastatin and Octreotide in patients with SAP In order to provide some experiences in clinical SAP treatment according to the theory and practice.patients with severe acute pancreatitis were randomly divided into experiment group treated with Ulinastatin combined with Octreotide, and control group treated only with Octreotide respectively to assess the therapeutic effect and complications of both groups.[Method]One hundred patients with severe acute pancreatitis were randomly divided into experiment group treated with Ulinastatin combined with Octreotide (n=50), and control group treated only with Octreotide (n=50), to assess the therapeutic effect and complications of both groups.[Results]In the50patients of the observation group,45patients being cured,3patients developed,1patient progressd,1patient invalided. Total effective rate is96.0%. In the50patients of the control group,33patients being cured,5patients developed,4patients progressd,8patients Invalided. Total effective rate is76.0%. Comparative analysis results show that the time of two groups of patients with abdominal pain and abdominal distension ease time, average hospitalization time comparison and transit operation rate has significant difference (P<0.05). The coparation of clinical efficacy of the two groups is of significant difference (X2=13.166, P<0.05). But there was no significant difference in, serious complication rate and mortality. Compared to the control group, the observation group has significantly reduced the value of hematuria amylase, hepatorenal function, Ieucocyte and C-Reactive protein.[Conclusion]The early use of Ulinastatin combined with Octreotide in treatments for severe acute pancreatitis, can shorten the urine amylase fall time, abdominal pain and abdominal distension ease time, patients with a mean length of hospital stay, and at the end of the treatment process found serious adverse reaction, it is worth clinical promotion use.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Pancreatic diseases
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