清胰汤和肠内营养序贯治疗重症急性胰腺炎的效果

The effect of Qingyi decoction combined with enteral nutrition in the sequential treatment of severe acute pancreatitis

目的:探讨清胰汤和肠内营养在重症急性胰腺炎治疗中的应用效果。方法:将41例重症急性胰腺炎患者分为治疗组21例)及对照组20例,对照组行常规治疗+肠外营养治疗,治疗组采用清胰汤和肠内营养序贯治疗。观察2组患者腹部症状及体征,记录肠功能恢复时间,观察胰周脓肿/假性囊肿发生率、病死率及住院时间。分别于入院24 h内及治疗后7 d、14 d,进行急性生理和慢性健康状况评估Ⅱ评分、血清白蛋白水平检测,并行上腹部CT检查,评定CT严重度指数。结果:治疗组肠功能恢复时间、血常规WBC恢复正常时间及住院时间均低于对照组(P<0.01)。治疗组治疗后7 d、14 d的急性生理和慢性健康状况评估Ⅱ评分和CT严重度指数均低于对照组(P<0.05～P<0.01),且血清白蛋白水平均高于对照组(P<0.01)。结论:清胰汤和肠内营养序贯治疗,明显促进病情的恢复,缩短住院时间,改善患者的预后,有较好的临床应用价值。

Objective： To explore the effects of Qingyi decoction combined with enteral nutrition（EN） in the sequential treatment of severe acute pancreatitis（SAP）.Methods： Forty-one patients with SAP were randomly divided into treatment group（21 cases） and control group（20 cases）.The control group were treated with routine method combined with parenteral nutrition,the treatment group were sequentially treated with Qingyi decoction combined with enteral nutrition.The abdominal symptoms and signs,time of intestinal function recovery,incidence of peripancreatic abscess / pseudocyst,fatality rate and hospital stays in two groups were recorded.The acute physiology and chronic health evaluation Ⅱ score,serum albumin concentration and CT scan of upper abdominal were investigated within 24 hours of admission and at 7th day,14th day after treatment.Results： The time of intestinal function recovery and WBC restore,and hospital stays in treatment group were less than those in the control group（P 0.01）.At 7 th and 14th day after treatment,the acute physiology and chronic health evaluation Ⅱ score and CT severity index in treatment group were lower than those in control group（P 0.05-P 0.01）,but its serum albumin concentration was high（P 0.01）.Conclusions： The sequential therapy of Qingyi decoction combined with enteral nutrition can significantly promote the disease recovery,short hospital stays and improve patient prognosis,which has better clinical application value.