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急性重症胰腺炎患者经鼻空肠管注入清胰汤治疗的临床疗效与安全性 被引量:8

Clinical efficacy and safety of Qingyi Decoction administered by nasojejunal tube for the treatment of severe acute pancrcatitis
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摘要 目的比较使用鼻胃管和鼻空肠管注入中药清胰汤对急性重症胰腺炎(SAP)的治疗效果与安全性。方法将纳入的79例SAP患者按照随机数字表法随机分为鼻胃管组(41例)和鼻空肠管组(38例),在常规治疗的基础上,分别经鼻胃管和鼻空肠管注入中药清胰汤进行治疗。结果开始治疗14d后鼻空肠管组C反应蛋白(CRP)、降钙素原(PCT)阳性率与白细胞计数(WBC)、膀胱压、APACHEII水平明显低于鼻胃管组,差异均有统计学意义(P〈0.05)。鼻空肠管组患者的肠鸣音恢复时间、血淀粉酶恢复时间、腹痛缓解时间、呼吸支持时间明显短于鼻胃管组,血液真菌感染率、肺部真菌感染率明显小于鼻胃管组,而28d生存率明显大于鼻胃管组,差异均有统计学意义(P〈0.05)。结论经鼻空肠管注入清胰汤治疗SAP与使用鼻胃管比较,能够有效地缓解患者病情,缩短临床症状改善时间,降低并发症发生率和病死率,值得在临床上进一步推广。 Objective To compare the clinical efficacy and safety of Qingyi Decoction ( a preparation of Chinese herbal medicine) between two different routes of the administration by using nasogastric tube or nasojejunal tube for treatment of severe acute pancreatitis (SAP). Methods A total of 79 SAP patients enrolled were randomly divided into nasogastric tube group ( n = 41 ) and nasojejunal tube group ( n = 38 ) according to the random number table method. In addition to the conventional therapy, they were treated with Qingyi Decoction administered by using nasogastric tube or nasojejunal tube. Results After treatment for 14 days, the levels of C-reactive protein ( CRP), procalcitonin (PCT) and white blood cell count ( WBC), urinary bladder pressure, and APACHE H score in nasojejunal tube group were significantly lower than those in nasogastric tube group (P 〈 0. 05 ). The time required for the recovery of bowel sounds, length of abnormal serum amylase persistence, the duration of abdominal pain, the time necessary for mechanical respiratory support in nasojejunal tube group was significantly shorter than those in nasogastric tube group. The blood fungus infection rate and pulmonary fungus infection rate in nasojejunal tube group were significantly lower than those in nasogastric tube group, and 28-day survival rate in nasojejunal tube group was significantly higher than that in nasogastric tube group (P 〈 0.05). Conclusion The nasojejunal tube route for the administration of Qingyi Decoction for the treatment of SAP can effectively alleviate the severity of patient' s condition, shorten the time required for improving clinical symptoms, reduce the incidence of morbidity and mortality, and it is worthy of further popularization in clinical practice.
出处 《中华急诊医学杂志》 CAS CSCD 北大核心 2016年第11期1439-1442,共4页 Chinese Journal of Emergency Medicine
关键词 急性重症胰腺炎 鼻空肠管 鼻胃管 清胰汤 临床疗效 Severe acute pancreatitis Nasojejunal tube Nasogastric tube Qingyi Decoction Clinical curative effect
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