| Acute pancreatitis is a one of a common critical illness, clinical to acute abdominal pain, fever accompanied by nausea, vomiting, and the increasing of blood and urine amylase In recent years, as a result of the clinical application of the somatostatin analogue octreotide, the treatment of acute pancreatitis has made great improvement.Objective: To observe the effects of octreotide in acute pancreatitis treatment efficacy, and to investigate its pharmacological effects in the pathogenesis of acute pancreatitis role.Materials and Methods: Retrospective analysis from January 2003 to January 2006 in our hospital 133 cases of patients with acute pancreatitis, according to clinical medicine, they can be divided into three different groups, namely, octreotide group (47cases), ulinastatin group (45cases), gabexate mesylate group (41cases). Delivery methods are put into three groups according to the conventional treatment, including fasting water, anti-acid, anti-inflammatory, analgesic, if necessary, decompression, parenteral nutrition support, to maintain water, electrolyte and acid-base balance etc, patients with the damaged liver are given the other, Jiangmei treatment. On this basis octreotide group are given 0.6mg, continuous 24h infusion, to be abdominal pain, bloating and other symptoms improve after the reduction to 0.3mg, 24h continuous infusion. or 0.3mg Subcutaneous injection three times one day.Ulinastatin group of 10 million units of intravenous infusion, 3 times one day until abdominal pain, bloating and other symptoms improved changed 2 times. Gabexate mesylate 100mg intravenous group, 2 times, to be abdominal pain, bloating and other symptoms improved changed 1 times. And then observe three groups before and after treatment of the main symptoms, signs and laboratory changes. Evaluation of therapeutic efficiency (1) abdominal pain, nausea, vomiting, fever and other symptoms disappeared; (2) muscle tension, abdominal tenderness or anti- jumping pain, jaundice and other signs disappeared; (3) serum amylase, urine amylase, laboratory indicators such as blood WBC returned to normal. Based on the above criteria, according to recover, effective and ineffective evaluation 4. (1) cure: achieve the above three standards at the same time in 5 days. (2) markedly : achieve the above three standards at the same time in 5-7 days. (3) Effective: 10 days at the same time to achieve the above three persons. (4) Inefficacy: more than 10 days invalid. The total effective rate = (number of cured cases + markedly the number of cases) /total number of observed cases.Results: (1) Octreotide can significantly improve the clinical symptoms and signs of acute pancreatitis.The remission rate of octreotide group symptoms and signs is 93.3% -100%, compared with ulinastatin group and gabexate mesylate group it has significant difference (P <0.05). (2) It can be used as dynamic detection of blood amylase, urine amylase, blood WBC in the treatment before and after the beginning of 3, 5, 7, 10-day. The results showed that the treatment group over the first three positive rates of the indicators has no significant difference (P>0.05), octreotide group after treatment of serum and urinary amylase and the WBC restoration of blood is better than ulinastatin, gabexate group, statistically significance (P<0.05), and after treatment at the beginning of five days it is particularly evident. (3) The main symptoms and signs of the majority of patients with octreotide group are remission rapidly after treatment for 3-5days, blood, urine amylase and blood WBC in 3-5 days, returned to normal, the number of days of fasting is more than 5 days. And ulinastatin group gabexate mesilate group were significantly different (P<0.05). (4) Three groups before treatment in patients with SAP blood WBC, AST, glucose, calcium and other laboratory indicator has no significant difference (P>0.05), after treatment the recovery is better than octreotide group and ulinastatin group, with significant difference (P<0.05). Octreotide can reduce the incidence of complications of SAP than ulinastatin group and gabexate mesylate group with significant difference (P<0.05), but the three groups SAP mortality compared with less than ulinastatin group gabexate mesylate group, but statistically no significant difference (P>0.05). (5) 64 cases of 133 cases of AP (48.1%) with liver damage, octreotide group after treatment is superior to the recovery of liver function ulinastatin and gabexate mesylate group, statistically significant difference (P <0.05). (6) Octreotide group was 91.5% efficient, ulinastatin group was 71.1%, gabexate mesylate group was 53.6%, the total effective with a significant difference (P<0.05). (7) the present study octreotide group and Group ulinastatin were no significant nausea, vomiting, skin rash, WBC decreased adverse reactions, etc, with good security.Conclusion: (1)Octreotide has a positive effect for AP, symptoms, signs ease quickly, the blood, urine amylase and blood WBC recovery quickly; (2) Octreotide is early applicated in the SAP, which reduces the incidence of complications; (3) In the case of AP associated with liver injury,octreotide has a good effect; (4) Octreotide is an effective and safe treatment of AP drugs,because of less adverse reactions and because efficacy is superior to ulinastatin and gabexate mesylate。...
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