Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.
Pancreas. 2010 May;39(4):516-9. doi: 10.1097/MPA.0b013e3181c3c954.
To study the effect of lower-molecular weight heparin in the prevention of pancreatic encephalopathy (PE) in the patient with severe acute pancreatitis (SAP).
Two hundred sixty-five SAP patients were randomly divided into 2 groups: (1) conventional treatment group (C group, n = 130) and (2) conventional treatment plus lower-molecular weight heparin treatment group (LT group, n = 135). The clinical parameters, laboratory parameters and computed tomographic (CT) score of pancreatic necrosis (CTSPN), incidence of PE, and mortality in the 2 groups were compared.
On admission, all the clinical parameters, laboratory parameters, and CTSPN in the 2 groups were not significantly different (P > 0.05). However, 1 to 2 weeks after treatment, the symptoms and signs improvement rate, the levels of blood and urine amylase, the CT score, and the Acute Physiology and Chronic Health Evaluation II score in the LT group were obviously lower than those in the C group (P < 0.05-0.01), and PE occurrence rate, mortality, and mean hospital stay in LT group were obviously lower than those in the C group (P < 0.05-0.01).
Lower-molecular weight heparin can enhance the effect of conventional treatment of SAP and can markedly decrease the PE incidence and improve the survival rate of SAP. Lower-molecular weight heparin is a simple, safe, less expensive, and effective method for treatment of SAP. It can be used in every hospital.
研究低分子肝素在预防重症急性胰腺炎（SAP）患者胰性脑病（PE）中的作用。
将 265 例 SAP 患者随机分为 2 组：（1）常规治疗组（C 组，n=130）和（2）常规治疗加低分子肝素治疗组（LT 组，n=135）。比较两组的临床参数、实验室参数和胰腺坏死的计算机断层扫描（CT）评分（CTSPN）、PE 发生率和死亡率。
入院时，两组的所有临床参数、实验室参数和 CTSPN 均无明显差异（P>0.05）。然而，治疗 1-2 周后，LT 组的症状和体征改善率、血、尿淀粉酶水平、CT 评分和急性生理学和慢性健康评估 II 评分明显低于 C 组（P<0.05-0.01），PE 发生率、死亡率和平均住院时间明显低于 C 组（P<0.05-0.01）。
低分子肝素能增强 SAP 的常规治疗效果，明显降低 PE 的发生率，提高 SAP 的生存率。低分子肝素是一种治疗 SAP 的简单、安全、经济、有效的方法。它可以在每家医院使用。
