内科

目的探讨早期应用地塞米松对急性胰腺炎治疗效果的影响。方法将150例急性胰腺炎患者随机分为治疗一组、治疗二组、对照组，每组50例，对照组患者给予常规方法治疗；治疗一组在对照组治疗的基础上，从初入院开始立即给予小剂量地塞米松静脉注射；治疗二组在对照组治疗的基础上，当病情加重时给予小剂量地塞米松静脉注射。观察比较三组患者治疗后腹痛缓解时间、血清（尿）淀粉酶恢复时间、胰周渗出吸收好转及平均住院天数等。结果与对照组相比，治疗一组及二组腹痛缓解时间、血清（尿）淀粉酶恢复时间、胰周渗出吸收好转及平均住院天数均明显缩短（P＜0.05）；除血清淀粉酶恢复时间外，其他指标治疗一组比二组均缩短（P＜0.05）。临床疗效比较，治疗一组优于对照组，但治疗二组与对照组比，差异无统计学意义。结论早期应用小剂量地塞米松可以明显降低血中炎症因子水平而降低胰腺炎程度，提高疗效。

ObjectiveTo study the treatment effect of small dosage of dexamethsone in patients with acute pancreatitis (AP) in the early time. Methods150 cases with AP were randomly allocated into three groups: treatment group one, treatment group two and control group, with 50 cases in each. Three groups were treated with conventional therapy, and the treatment group one was also received small dosage of dexamethsone as soon as be hospitalized, while treatment group two given small dosage of dexamethsone when the illness was worse. The time of abdominal pain relief, absorption of peripancreatic effusion and recovery time of serum amylase(urine), and the average hospitalization days were compared between the 3 groups. ResultsThe time of abdominal pain relief, absorption of peripancreatic effusion and recovery time of serum amylase (urine), and the average hospitalization days of treatment groups were significantly shorter than those of control group (P＜0.05); in addition to the recovery time of serum amylase, the time of other indexes in the treatment group one was shorter than that of treatment group two (P＜0.05). The clinical curative effect in the treatment group one was significantly better than that in the treatment group two, but there was no statistical difference between treatment group two and control group. ConclusionsSmall dosage of DXM in early time may reduce the severity of acute pancreatitis by restraining expression of acutephase tissue inflammatory factor.