Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

Purpose: To explore the clinical effects of low-molecular-weight heparin (LMWH) combined with ulinastatin (UTI) in children with acute pancreatitis.
Methods: In total, 560 patients with severe acute pancreatitis treated at Binzhou People’s Hospital, Shandong, China, from April 2012 to June 2014 were enrolled in this study. They were divided into control (280 patients, ulinastatin + conventional treatment) and observational groups (280 patients, LMWH + ulinastatin + conventional treatment). The treatment lasted for 2 weeks. Clinical parameters, laboratory test indices, Acute Physiology and Chronic Health Evaluation (APACHE II) score, and computed tomography score of pancreatic necrosis (CTSPN) were assessed in both groups.
Results: On admission, no significant differences were noted in clinical features, laboratory parameters, APACHE II scores, or CTSPN between the two groups (all p > 0.05). After 2 weeks of treatment, serum amylase, urine amylase, prothrombin time, fibrinogen, partial thromboplastin time, and platelet count in the study group were 913 ± 281 U/L, 1893 ± 295 U/L, 16 ± 1.60 s, 3 ± 0.60 g/L, 39.80 ± 5.60 s, and 294 ± 49 × 10⁹/L, respectively, all of which were similar or superior to those in the control group (1738 ± 346 U/L, 2453 ± 473 U/L, 15 ± 1.50 S, 2.50 ± 0.50, 39.80 ± 5.90, and 192 ± 37 × 10⁹/L)). APACHE II scores and CTSPN after 2 weeks of treatment in the observation group were 8.50 ± 1.80 and 2.10 ± 1, respectively, which were superior to those in the control group (9.60 ± 2.40 and 4.30 ± 2.60, respectively; p < 0.05). Moreover, the incidence of complications, mortality rate, and average duration of the hospital stay in the observation group were lower than those in the control group (p > 0.05). The cure rate in the observation group was higher than that in the control group.
Conclusions: LMWH combined with UTI enhances the efficacy of conventional treatment and reduces mortality. Thus, it is a potentially effective treatment strategy for severe acute pancreatitis in children.

Keywords
Acute pancreatitis; Low-molecular-weight heparin; Multiple organ function syndrome; APACHE II score; Pancreatic necrosis