乌司他丁联合金属胆道支架对肝外胆道梗阻胰腺癌的治疗效果

doi:10.3969/j.issn.1004-616x.2023.04.008

癌变·畸变·突变 ›› 2023, Vol. 35 ›› Issue (4): 292-295,319.doi: 10.3969/j.issn.1004-616x.2023.04.008

乌司他丁联合金属胆道支架对肝外胆道梗阻胰腺癌的治疗效果

李伟¹, 吴胜¹, 田宇剑¹, 唐晓明¹, 蔡创¹, 胡浩²

1. 中国人民解放军联勤保障部队第九〇四医院/无锡市太湖医院, 肝胆外科, 江苏无锡 214044;
2. 江南大学附属医院南院, 江苏无锡 214122

收稿日期:2023-04-02 修回日期:2023-06-21 出版日期:2023-07-30 发布日期:2023-08-04
通讯作者: 胡浩
作者简介:李伟，E-mail：29414015@qq.com。
基金资助:
江苏省自然科学基金面上项目(BK20191142)

Effect of ulinastatin combined with metal biliary stent on pancreatic cancer with extrahepatic biliary obstruction

LI Wei¹, WU Sheng¹, TIAN Yujian¹, TANG Xiaoming¹, CAI Chuang¹, HU Hao²

1. Department of Hepatobiliary Surgery, The Chinese People's Liberation Army 904 Hospital/Wuxi Taihu Hospital, Wuxi 214044;
2. Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu, China

Received:2023-04-02 Revised:2023-06-21 Online:2023-07-30 Published:2023-08-04

摘要/Abstract

摘要： 目的：探讨乌司他丁联合金属胆道支架对肝外胆道梗阻胰腺癌的治疗效果。方法：选取92例肝外胆道梗阻胰腺癌患者，依照随机数表法分为对照组和观察组，每组46例。对照组采用金属胆道支架置入治疗，观察组在对照组治疗的基础上另给予乌司他丁治疗，两组均治疗2个月。比较两组患者治疗前后肝功能总胆红素(TBiL)、谷草转氨酶(AST)浓度，治疗前后血尿酸(UA)，尿素氮(BUN)浓度变化，治疗后临床疗效以及不良反应发生情况。结果：治疗后两组AST、TBiL浓度均低于治疗前(P<0.05)，且观察组AST、TBiL浓度均低于对照组(P<0.05)。治疗后两组患者血UA、BUN浓度均降低(P<0.05)，且观察组低于对照组(P<0.05)。观察组总有效率(97.83%)高于对照组(82.61%)(P<0.05)。治疗期间观察组出现恶心、呕吐、腹泻各1例，不良反应的发生率为6.52%(3/46)，对照组有2例恶心，不良反应发生率为4.35%(2/46)，不良反应的发生率对比差异无统计学意义(校正χ²值=0.211，P=0.646)。治疗后两组炎症因子浓度均低于治疗前(P<0.05)，且观察组炎症因子浓度均低于对照组(P<0.05)。结论：乌司他丁联合金属胆道支架置入治疗肝外胆道梗阻胰腺癌患者，能够改善肝肾功能，提高疗效，且可降低炎症因子，改善免疫功能，具有一定的临床推广应用价值。

关键词: 乌司他丁, 金属胆道支架置入, 胰腺癌, 胆道梗阻

Abstract: OBJECTIVE： To investigate effects of ulinastatin in combination with metal biliary stent on pancreatic cancers which were caused by extrahepatic biliary obstruction. METHODS： A total of 92 pancreatic cancer patients with extrahepatic biliary obstruction were selected and ewually divided into control and observation groups according to the random number table method. The control group was treated with metal biliary stent implantation alone，and the observation group was treated in combination with ulinastatin for two weeks. Before and after the treatments，concentrations of liver function total bilirubin (TBiL) and aspartate aminotransferase (AST)，and changes of blood uric acid (UA) and urea nitrogen (BUN) were determined. In addition，clinical efficacy and occurrence of adverse reactions after the treatment were compared between the two groups. RESULTS： After the treatment，AST and TBiL concentrations in the two groups were lower than before treatment (P<0.05)，and AST and TBiL concentrations in the observation group were lower than control group (P<0.05). After treatment，blood UA and BUN concentrations in the two groups were reduced (P<0.05)，and the observation group was lower than that in the control group (P<0.05). The total effective rates in the observation group (97.83%) was higher than that of the control group (82.61%) (P<0.05). During treatment，there was 1 case of nausea，1 case of vomiting and 1 case of diarrhea in the observation group，and the incidence of adverse reactions was 6.52% (3/46)，while 2 cases of nausea and 4.35% (2/46) were in the control group，there was no difference in the incidence of adverse reactions (correction value χ²=0.211，P=0.646). After treatment，the concentration of inflammatory factors in the two groups was lower than that before treatment (P<0.05)，and the concentration of inflammatory factors in the observation group was lower than that in the control group (P<0.05). CONCLUSION： Ulinastatin in combination with metal biliary stent implantation improved liver and kidney functions，enhanced efficacy and safety，reduced inflammatory factors，and improved immune functions among pancreatic cancer patients with extrahepatic biliary obstruction.

Key words: ulinastatin, metal biliary stent implantation, pancreatic cancer, biliary obstruction

中图分类号:

R735.9

李伟, 吴胜, 田宇剑, 唐晓明, 蔡创, 胡浩. 乌司他丁联合金属胆道支架对肝外胆道梗阻胰腺癌的治疗效果[J]. 癌变·畸变·突变, 2023, 35(4): 292-295,319.

LI Wei, WU Sheng, TIAN Yujian, TANG Xiaoming, CAI Chuang, HU Hao. Effect of ulinastatin combined with metal biliary stent on pancreatic cancer with extrahepatic biliary obstruction[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2023, 35(4): 292-295,319.

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乌司他丁联合金属胆道支架对肝外胆道梗阻胰腺癌的治疗效果

Effect of ulinastatin combined with metal biliary stent on pancreatic cancer with extrahepatic biliary obstruction

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