不同途径注入大黄治疗急性重症胰腺炎

Treatment of severe acute pancreatitis by different administration route:a comparative analysis

目的:对比研究经胃管和鼻空肠管不同途径给予大黄治疗急性重症急性胰腺炎的治疗效果.方法:SAP患者43例随机分为A组(n=20)和B组(b=23).在综合治疗基础上A组给予胃管注入大黄,B组给予鼻空肠管注入大黄,观察患者住院7、14 d时APACHE-Ⅱ评分,Balthazar CT积分以及CRP及血淀粉酶,肠道功能恢复时间.结果:治疗7 d时B组APACHE-Ⅱ评分较A组有明显降低(3.76±2.82 vs 4.58±2.07,P<0.05),Balthazar CT积分无明显差别(P>0.05):治疗14 d时A组与B组APACHE-Ⅱ评分、Balthazar CT积分均无明显差别(P>0.05);B组CRP及肠功能恢复时间较A组有明显缩短(8.3±1.7 vs 9.1±3.6,P<0.05:6.2±2.9 vs 8.5±2.3.P<0.01).结论:鼻空肠管途径应用大黄能更有效的地控制急性重症胰腺炎的全身炎症反应,缩短病程.

AIM： To compare the efficacy of rude rhubarb in the treatment of severe acute pancreatitis （SAP） by nasogastric or nasojejunal feeding. METHODS： SAP patients were divided into group A （n = 20） and B （n = 23） randomly. Based on comprehensive treatment, the patients in group A were given rude rhubarb by nasogastric feeding, while those in group B were given rude rhubarb by nasojejunal feeding. The APACHE-Ⅱ score and Balthazar CT score on the 7th and 14th day were observed, and the level of serum C-reactive protein （CRP） and amylase and the intestinal function were also detected. RESULTS： On day 7, the APACHE-Ⅱ score in group B was significantly lower than that in group A （3.76±2.82 vs 4.58±2.07, P 〈 0.05）, but Balthazar CT score had no marked difference between the two groups （P 〉 0.05）. On day 14, both the APACHE-Ⅱ score and Balthazar CT score were not notably different between group A and B （P〉 0.05）. The recovery time of CRP and intestinal function had significant differencesbetween group B and A （8.3 ±1.7 vs 9.1 ±3.6, P 〈 0.05; 6.2 ±2.9 vs 8.5 ±2.3, P 〈 0.01）. CONCLUSION： Application of rude rhubarb by nasojejunal feeding can more effectively control the systemic inflammation in SAP and shorten the course of disease.