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目的探讨早期经鼻饲及保留灌肠应用生大黄对重症急性胰腺炎(SAP)的疗效。方法将60例SAP患者随机分为两组,大黄治疗组28例和常规治疗组32例,常规治疗组按SAP常规予禁食、胃肠减压、液体复苏、抑酸、应用生长抑素、抗感染及纠正水、电解质、酸碱失衡等治疗;大黄治疗组在常规治疗的基础上早期给予生大黄液经胃管注入及保留灌肠。观察两组患者的腹痛缓解时间、胃肠道功能恢复时间、全身炎症反应综合征(SIRS)改善时间、血淀粉酶恢复时间、并发症发生率、病死率及平均住院日。结果大黄治疗组患者的腹痛缓解时间为(6.1±2.1)d,胃肠道功能恢复时间为(7.2±1.9)d,SIRS改善时间为(8.1±1.3)d,血淀粉酶恢复时间为(9.6±1.3)d,并发症发生率为25%,病死率为3.6%,平均住院时间日为(18.2±9.1)d,均较常规治疗组显著降低(P<0.05)。结论早期应用生大黄液经胃管注入及保留灌肠治疗SAP可显著改善病情、缩短病程、减少并发症的发生,改善患者预后。
Objective To investigate the effect of nasal feeding and retention enema on rhubarb for severe acute pancreatitis (SAP). Methods Sixty patients with SAP were randomly divided into two groups: rhubarb treatment group (n = 28) and conventional treatment group (n = 32). Conventional treatment group were given routine SAP according to SAP, including fasting, decompression, fluid resuscitation, Anti-infective and correct water, electrolyte, acid-base imbalance and other treatment; Rhubarb treatment group on the basis of conventional treatment of early given rhubarb fluid through the gastric tube and retention enema. Abdominal pain relief time, gastrointestinal function recovery time, systemic inflammatory response syndrome (SIRS) improvement time, blood amylase recovery time, complications, mortality and average length of stay were observed in two groups. Results The pain relief time was (6.1 ± 2.1) days, the function recovery time of gastrointestinal function was (7.2 ± 1.9) days, the improvement time of SIRS was (8.1 ± 1.3) days and the recovery time of serum amylase was (9.6 ± 1.3) d. The complication rate was 25%, the case fatality rate was 3.6%, and the average length of stay was (18.2 ± 9.1) days, both significantly lower than those in the conventional treatment group (P <0.05). Conclusion Early application of rhubarb via gastric tube infusion and retention enema treatment of SAP can significantly improve the condition, shorten the course of the disease, reduce the incidence of complications and improve the prognosis of patients.