低分子肝素对急性胰腺炎患者预后的改善作用
焦华波 乔治 谭向龙 杜俊东 费阳 王大东 李基业 姚咏明 【摘要】 目的 观察低分子肝素抗凝治疗对急性胰腺炎患者预后的影响。 方法 将41例急性胰腺炎患者随机分为抗凝治疗组(17例)和常规治疗对照组(24例)。抗凝治疗组给予低分子肝素钠40 mg或低分子肝素钙0.01 ml/kg皮下注射，12 h 1次；其他治疗同常规治疗对照组。观察两组患者的血清酶学及预后。 结果 低分子肝素抗凝治疗能明显改善急性胰腺炎患者的血象及动脉血氧分压变化，缩短住院时间,并能在一定程度上降低急性水肿型胰腺炎的重症化率，减少其二次手术率，降低病死率。低分子肝素抗凝治疗并没有加重急性胰腺炎的出血倾向或出血并发症。结论 低分子肝素抗凝治疗对急性胰腺炎是安全、有效的，能明显改善急性胰腺炎患者的预后。
【关键词】 低分子肝素； 抗凝治疗； 胰腺炎，急性
Effects of anticoagulation therapy with low molecular weight heparin in acute pancreatitis
JIAO Hua-bo, QIAO Zhi, TAN Xiang- long, DU Jun-dong, FEI Yang, WANG Da- dong, LI Ji- ye, YAO Yong-ming.
304th Division, General Hospital of PLA, Beijing 100037, China
【Abstract】 OBJECTIVE: To evaluate the effects of anticoagulation therapy with low molecular weight heparin in acute pancreatitis. METHODS: Low molecular weight heparin, in a dose of 40 mg or 0.01 ml/kg, by subcutaneous injection, every 12 hours, was administered to 17 acute pancreatitis patients combined with conventional therapy. The changes of serum enzymology and prognosis in patients treated with low molecular weight heparin or conventional therapy were observed. RESULTS: Anticoagulation by low molecular weight heparin could significantly decrease the blood white cell count of patients with acute pancreatitis and increase their arterial blood oxygen partial pressure. It could cut down the duration of hospitalization and reduce the aggravation rate, secondary operation rate, and mortality of these patients without increasing hemorrhagic tendency or its related complications. CONCLUSION: Anticoagulation therapy with low molecular weight heparin is safe and effective in the treatment of acute pancreatitis, and it may improve its prognosis. ......
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