| Acute pancreatitis has long been considered to be an autodigestive disorder, in which the parenchymal tissue of the organ is destroyed by its own digestive proteases, which is one of the most common emergency in digestive system. It's characterized by the sudden acute abdominal pain, the fever accompanied with vomiting and nausea, an increase in digestive enzyme levels in blood and urine. In recent years, the treament for acute pancreatitis has get many developments since octreotide, an analogue of somatostatin, which trade name is santostatin (made by Novartis Pharma Schweiz AG, Switzerland), is applied in the cure of this kind of disorder. Our object is to assess the difference between the two way, subcutaneous injection and intravenous drip, in which Sandostatin is given to treat acute pancreatitis. The object of our study include 169 pantients with acute edematous pancreatits (AEP) or acute necrosis pancreatitis (ANP) which were treated in digestive or surgery office, JiLin university. No. 1. hospital. from January, 1999 to September, 2003. 112 patients with AEP were divided into four groups according to age and the way that Sandostatin was given. 57 patients with ANP were divided into two groups according to the way sandostatin was given. Abdominal pain duration; vomiting and nausea duration; fever duration; the incidence of complications and surgery; mortality; occurrence rate of accute necrosis pancreatitis (ANP) were investigated and compared. Result: ①in patients with AEP whose age>55, abdominal pain duration was (2.6±1.5) days in sandostatin intravenous drip group and (4.7±1.5) days in subcutaneous group respectively (p<0.05); tenderness duration was (2.8±1.4) days in intravenous drip group, (5.0±1.2) days, in subcutaneous group; vomiting and nausea duration was (2.5±1.4) days in intravenous group, while (4.3±1.2) days in subcutaneous group (p<0.05); the postive rate of amylase in serum on the fifth day after treatment was 4.8% in intravenous group and 20% in subcutaneous group (p<0.05); the occurrence rate of ANP was 4.8% in intravenous group and 20% in subscutaneous one (p<0.05); incidence of surgery and mortality have no differences between two groups; the intravenous group is better than the subcutaneous one in total effective rate, p<0.05. ② in pantients with AEP whose age≤55, we didn't found that there is differences in abdominal pain, vomiting and nausea, fever, tenderness duration between intravenous and subcutaneous groups, p>0.05; the postive rate of amylase in blood on the third day after treatment were 11.1% and 23.5% in intravenous and subcutaneous group respectively, p<0.05; there is no patients developed to surgery, ANP, or was dead in two groups; in patients with AEP which cause was the disorder of biliary tract, the postive rate of WBC and AST in blood was significantly higher than that of the group which cause was others, but there were no differences between the intravenous and subcutaneous groups; we didn't found differences in total effective rate between two groups. ③ in patients with ANP, abdominal pain duration was (5.65±3.95) days in intra-group, and (10.3±3.23) days in sub-group; tenderness duration was (2.8±1.4) days in intra group, and (5.0±1.2) days in sub-one; fast duration was (10.9±6.10) days in intra-group, (18.9±1.2) days in sub-one, p<0.01; abdominal hypermyotonia duration was (4.72±2.29) days in intra-group and (9.75±3.28) days in sub-group; the intravenous group is better than the subcutaneous one in total effective rate, p<0.05. ④ we didn't found side-effect in all groups. So we can conclude that: Sandostatin has definite effect on treatment for acute pancreatitis; we can protect patients with AEP whose age>55, or ANP from developing into severe state, if they were given sandostatin as soon as possible. we can get higher and more steady concentration of sandostatin in serum in the way that sandostatin was given to patients with AP in intravenous drip, it can shorten the course of the disease and improve progness.
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