摘要
目的探讨中药清胰方联合肠内营养和腹腔微创引流治疗重症胰腺炎的临床疗效。方法选择2015年1月至2017年12月就诊的急性重症胰腺炎患者120例,随机分为对照组和研究组,每组60例。对照组早期给予肠内营养和腹腔微创引流治疗,研究组在对照组基础上联合中药清胰方治疗。比较2组患者临床疗效、血浆蛋白相关指标、肠功能指标及继发脏器损伤指标变化。结果治疗组总有效率为93.33%显著高于对照组的70.00%(P<0.05);2组患者治疗前血浆蛋白相关指标(总蛋白、白蛋白、前蛋白和转铁蛋白)差异无统计学意义(P>0.05),治疗后四指标均优于治疗前,且研究组优于对照组(P<0.05);研究组患者腹痛缓解、腹胀缓解、肠鸣音缓解及肛门排便肠功能指标恢复正常时间明显短于对照组(P<0.05);研究组患者血、尿淀粉酶水平恢复正常时间明显短于对照组(P<0.05);研究组治疗中出现急性呼吸窘迫综合征(ARDS)、多器官功能障碍综合征(MODS)、急性肾功能衰竭(ARF)、上消化道出血、腹腔脓肿等继发脏器损伤人数显著低于对照组(P<0.05)。结论中药清胰方联合肠内营养和腹腔微创引流治疗重症胰腺炎取得不错的临床效果,有助于改善患者的整体营养状况,促进患者肠道功能恢复,阻止内毒素、炎性因子吸收,减少继发性脏器组织损伤。
Objective To investigate the therapeutic effects of Qingyi decoction combined with enteral nutrition and minimally invasive peritoneal drainage on acute severe pancreatitis.Methods A total of 120 patients with acute severe pancreatitis who were treated in our hospital from January 2015 to December 2017 were randomly divided into control group(n=60) and research group(n=60).The patients in control group were treated by early enteral nutrition and minimally invasive abdominal drainage,however,the patients in research group,on the basis of control group, were treated by Qingyi decoction.The clinical curative effects,plasma protein related indexes,intestinal function indexes and secondary organ injury indexes were observed and compared between the two groups.Results The total effective rate in research group was 93.33%,which was significantly higher than that(70.00%) in control group(P<0.05).Before treatment there were no significant differences in plasma protein related indexes between the two groups(P<0.05).After reatment,the four indexes in both groups were superior to those before treatment,moreover,which in research group were superior to those in control group(P<0.05).In addition the recovery time of abdominal pain relief,abdominal distention relief,bowel sounds relief and anal defecation in research group was significantly shorter than that in control group(P<0.05),and the recovery time of serum and urinary amylase levels in research group was(6.1±1.4) days,(7.6±1.1) days,respectively,which in in research group was significantly shorter than that in control group(P<0.05). The numbers of patients with secondary organ injuries including acute respiratory distress syndrome(ARDS), multiple organ dysfunction syndrome(MODS),acute renal failure(ARF),upper gastrointestinal hemorrhage and abdominal abscess in research group were significantly lower than those in control group(P<0.05).Conclusion Qingyi prescription combined with enteral nutrition and minimally invasive abdominal drainage can obtain satisfactory therapeutic effects on acute severe pancreatitis,which is helpful to improve the overall nutritional status of patients,promote the recovery of intestinal function,prevent the absorption of endotoxin and inflammatory factors,and reduce secondary organ and tissue injury.
作者
康志龙
王辉
KANG Zhilong;WANG Hui(Department of Surgery,Xinle Municipal Hospital,Hebei,Xinle 050700, China)
出处
《河北医药》
CAS
2019年第9期1308-1312,共5页
Hebei Medical Journal
基金
河北省科学技术研究与发展支撑计划项目(编号:20141725)
关键词
胰腺炎
重症
清胰方
肠内营养
腹腔
引流术
severe pancreatitis
Qingyi decoction
enteral nutrition
abdominal cavity
drainage
