摘要
目的探讨早期持续区域动脉灌注对重症急性胰腺炎(severe acute pancreatitis,SAP)的治疗效果,选择合理的药物配伍,研究早期判断SAP病情严重程度的可靠指标。方法24只健康杂种犬,随机分为正常对照组(normal control,NC,n=6),重症急性胰腺炎组(SAP,n=6),区域动脉灌注组(regional arterial infusion,RAI,n=6),周围静脉给药组(periphery vein,PV,n=6)。胰管内注射5%牛磺胆酸钠(1ml/kg),制备SAP模型。以微泵早期持续区域动脉灌注奥曲肽、N-乙酰半胱氨酸、复方丹参及周围静脉给药。术后动态观察各组各时相点血淀粉酶(amylase,AMS)、肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)和NF-κB及胰腺病理变化,同时比较干预组上述指标变化情况。结果RAI组干预24h后胰腺病理变化明显好于SAP及PV组,AMS,TNF-α和NF-κB也较低。结论RAI治疗SAP,明显优于PV给药;奥曲肽、N-乙酰半胱胺酸、复方丹参注射液是早期治疗SAP较为理想的药物配伍;而TNF-α和NF-κB很可能是早期判断SAP病情严重程度的可靠指标。
Objective To explore therapeutic efficacy of RAI in SAP, and choose a reasonable medicine compatibility, then study a reliable index to judge earlier the severe degree of SAP. Methods Twenty-four healthy mongrel dogs were divided randomly into four groups：including normal control group （NC, n=6）, severe acute pancreatitis group （SAP, n=6）, regional arterial infusion group （RAI, n=6）, periphery vein group （PV, n=6 ）. 5% sodium taurocholate was pumped into Wirsung duct to establish the model of SAP. Earlier continuous regional arterial infusion with Octreotide, N-acetylcysteine and complex salviae mihiorrhizae using a minipump. Every groups,including Amylase, TNF-α,NF-κB,and pathological change of pancreas were observed, at the same time, the indices mentioned above in interfered group were compared. Results After interfered for 24 h, pathological changes of pancreas in RAI group were obviously better than that in SAP and PV groups. AMS, TNF-α and NF-κB were also lowered. Conclusion Regional arterial infusion is obviously better than periphery vein injection in the treatment of SAP. Octreotide, N-acetylcysteine and complex salviae miltiorrhizae are a good medicine compatibility in the earlier therapy of SAP. It maybe a reliable index for TNF-α and NF-κB to judge the severe degree of SAP.
出处
《肝胆胰外科杂志》
CAS
2007年第4期227-230,共4页
Journal of Hepatopancreatobiliary Surgery
