硫酸镁与甘露醇联合应用在急性重症胰腺炎患者肠功能恢复的疗效分析

Efficacy of magnesium sulfate combined with mannitol in the recovery of intestinal function in patients with severe acute pancreatitis

目的比较硫酸镁和甘露醇联合应用与单独使用在急性重症胰腺炎患者肠功能恢复过程中的疗效。方法 2015年1月至2017年5月,青岛市市立医院肝胆外科收治63例急性重症胰腺炎患者,按照入院先后顺序分为硫酸镁组、甘露醇组和混合组(硫酸镁联合甘露醇组),各21例,每组患者均按重症胰腺炎常规处理原则给予治疗。在此治疗的基础上,硫酸镁组:50%硫酸镁50ml鼻肠管注入,2次/天;甘露醇组:20%甘露醇50ml鼻肠管注入,2次/天;混合组:50%硫酸镁25ml+20%甘露醇25ml鼻肠管注入,2次/天。结果治疗7天后,腹围、腹压、APACHEⅡ评分及C-反应蛋白(c-reactive protein, CRP)各治疗组均有明显改善,较治疗前有统计学差异(P<0.05);混合组以上各指标递减最明显,混合组与前两组分别比较有统计学差异;甘露醇组递减次之,治疗后的硫酸镁组和甘露醇组的腹压变化无统计学差异(P>0.05)。针对治疗7天后患者恢复自主排便的时间及腹痛腹胀症状消失时间的变化,其中硫酸镁组与甘露醇组组间比较时间变化无明显差异,但混合组(硫酸镁联合甘露醇组)与前两组比较,时间均明显缩短,有统计学意义(P<0.05)。结论硫酸镁和甘露醇联合应用在急性胰腺炎中的效果突出可靠,值得推广应用。

Objective To compare the efficacy of Magnesium Sulfate and mannitol in the recovery of intestinal function in patients with severe acute pancreatitis. Methods From January 2015 to May 2017, 63 patients with severe acute pancreatitis were divided into A, B, and group C, 21 patients was in each group. Each group was treated with the principle of severe acute pancreatitis. On the basis of this treatment, group A-simple Magnesium Sulfate group： 50% Magnesium Sulfate 50ml nasal intestinal tube injection, 2 /d; group B- mannitol group： 20% mannitol 50ml nasal intestinal tube injection, 2 times /d; group C -mixed group： 50% Magnesium Sulfate 25ml＋20% mannitol 25ml naso intestinal tube injection, 2 times /d. Results After the treatment of 7 days, abdominal circumference, abdominal pressure, APACHE II score and C-反应蛋白（c-reactive protein, CRP） were statistically different between the 3 groups （P〈0.05）. The decrease of each index in group C was the most obvious, and there was a statistical difference between the group C and the first two groups; the B group decreased gradually, and there was no statistical difference between the group A and the B group （P〉0.05）. The time of recovery of self defecation and the disappearance time of abdominal pain and abdominal distention were statistically significant after 7d treatment. There was no significant difference in time between group A and group B, but the time of recovery of self defecation and the disappearance time of abdominal pain and abdominal distention in group C were significantly shorter than those in the first two groups. Conclusion The combined application of Magnesium Sulfate and mannitol in acute pancreatitis is effective and worthy for popularization and application.