内镜介入联合生长抑素对重症急性胰腺炎患者血清炎性因子及胃肠功能的影响

The influence of endoscopic intervention combined somatostatin serum inflammatory factors and gastrointestinal function in patients with severe acute pancreatitis

目的探讨内镜介入联合生长抑素对重症急性胰腺炎(SAP)患者血清炎性因子及胃肠功能的影响,分析联合治疗可能作用机制。方法选择2013年5月至2015年4月收治的重症急性胰腺炎患者70例为研究对象,采用随机数字表法分为观察组和对照组各35例。对照组给予常规禁食、持续胃肠减压、抑酸及大剂量生长抑素静滴治疗,观察组联合应用内镜介入治疗。治疗1周后,比较两组临床症状改善时间、血清炎性因子、胃肠激素、并发症等指标。结果观察组患者恶心呕吐缓解时间、腹痛腹胀缓解时间、体温恢复正常时间、自行排气时间均明显短于对照组(P<0.05);血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)含量均明显低于对照组(P<0.01);血清胃动素(MTL)含量明显高于对照组,胃泌素(GAS)含量明显低于对照组(P<0.05);胰腺及周围组织坏死等并发症14.29%明显低于对照组60.00%(P<0.05)。结论内镜介入联合生长抑素治疗有助于改善重症急性胰腺炎患者临床症状,减少并发症发生,可能与调节患者血清炎性因子水平、促进胃肠功能恢复等因素有关。

Objective To investigate the influence of endoscopic intervention combined somatostatin serum inflammatory factors and gastrointestinal function in patients with severe acute pancreatitis.Methods From May 2013 to April 2013,70 cases of severe acute pancreatitis patients were selected as the research object,according to the random number table method they were divided into observation group and control group,35 cases in each group.The control group were given conventional fast,continuous gastrointestinal decompression,acid suppression,and a large dose of somatostatin static treatment,observation group of combined application of endoscopic interventional treatment.1 week after treatment,clinical symptoms improved time,serum levels of inflammatory cytokines,gastrointestinal hormone,complications in two groups were compared.Results Nausea and vomiting,abdominal pain relief time abdominal distension relief time,body temperature returned to normal time,exhaust time of observation group were significantly shorter than those of the control group(P < 0.05).Serum tumor necrosis factor alpha(TNF alpha),interleukin 6(IL-6) and interleukin 8(IL-8) levels were significantly lower than those of the control group(P < 0.05).Serum gastric dynamic element(MTL) levels were significantly higher than that of the control group,the stomach gastrin-releasing(GAS) content was significantly lower than that of the control group(P < 0.05).The pancreas and the surrounding tissue necrosis complications(14.29%) were significantly lower than those of the control group(60.00%)(P < 0.05).Conclusion Endoscopic intervention combined with somatostatin therapy can help improve clinical symptoms in patients with severe acute pancreatitis,and reduce the incidence of complications.This may be related to the regulation of the level of gastrointestinal function,promotion of the level of serum inflammatory.