目的：研究血必净联合国产十四肽治疗急性出血坏死性胰腺炎（ AHNP）的疗效。方法选取2013年11月至2014年5月南通市通州区人民医院收治的 AHNP患者60例，采用随机数字表法分为观察组和对照组，各30例。对照组在常规治疗基础上给予国产十四肽生长抑素100μg，缓慢静脉注射后再予以250μg／h的速度静脉泵入，连续治疗7 d。观察组在对照组治疗的基础上给予血必净注射液50 mL静脉滴注，每日2次。记录患者就诊当日及治疗3 d及5 d后体液淀粉酶（淀粉酶检测试剂盒检测法）；记录患者腹胀腹痛时间、恶心呕吐时间、禁食时间、退热时间、住院时间及并发症发生率。结果两组治疗后血淀粉酶、尿淀粉酶随时间推移逐渐下降，且观察组下降幅度大于对照组，组间、不同时点间、组间·不同时点间交互作用差异有统计学意义（ P＜0.01）。观察组患者平均腹胀腹痛时间、恶心呕吐时间、禁食时间、退热时间、住院时间、并发症发生率显著低于对照组[（2.5±1.3） d 比（4.4±1.3） d，（3.6±1.0）d 比（5.1±1.1） d，（8.4±1.2） d 比（12.0±1.4） d，（4.9±1.4） d 比（7.1±1.7） d，（16.7±2.0） d 比（21.8±2.7） d，26.7％（8／30）比36.7％（11／30），均P＜0.01]。结论血必净联合国产十四肽治疗AHNP疗效确切，值得推广。%Objective To study the effect of xuebijing combined domestic fourteen peptide therapy for acute hemorrhagic necrotizing pancreatitis(AHNP).Methods Total of 60 patients with AHNP admitted to Tongzhou District People′s Hospital from Nov.2013 to May 2014 were included in the study.The patients were divided into observation group and ontrol group ( 30 cases each ) according to random number table method.The control groupwas given domestically produced fourteen peptide somatostatin(100 μg slow bolus then 250 μg/h intravenous infusion) based on conventional treatment,continuously for 7 days.The observa-tion group received xuebijing injection(50 mL intravenous injection,twice a day) on the basis of the control group′s therapy.The body fluid amylase(EPS assay) of the patients on the first visit and 3 d and 5 d after treatment were recorded;the abdominal bloating and pain, nausea and vomiting, fasting, the incidence of fever,length of hospital stay and complications of the patients were recorded.Results The blood amylase and urine amylase of both groups declined gradually after treatment, observation group declined faster,and the difference between the two groups different time points; groups time points, time points and different groups interactive effects had significont difference (P<0.01).The average abdominal bloating and pain, nausea and vomiting,fasting,fever,hospital stay,and complications of the observation group were significantly lower than the control group[(2.5 ±1.3) d vs (4.4 ±1.3) d,(3.6 ±1.0)d vs (5.1 ±1.1) d,(8.4 ± 1.2) d vs (12.0 ±1.4) d,(4.9 ±1.4) d vs (7.1 ±1.7) d,(16.7 ±2.0) d vs (21.8 ±2.7) d,26.7%vs 36.7%,all P <0.01 ] .Conclusion Xuebijing combined with domestic peptide treatment of AHNP is effective,and worthy of promotion.
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