谷氨酰胺治疗危重症感染合并胃肠道功能障碍的临床疗效观察

Clinical Efficacy of Glutamine in the Treatment of Severe Infection with Gastrointestinal Dysfunction

目的:探究应用谷氨酰胺治疗危重症感染合并胃肠道功能障碍的临床疗效观察。方法:此次研究所选的90例对象为河南省罗山县人民医院收治的危重症感染合并胃肠道障碍患者(均为2017年4月～2018年4月期间).采用抽签分组法将患者分成两组,患者则根据抽签结果加入对照组或观察组。对照组共45例患者,仅接受常规治疗;观察组共45例患者,在对照组基础上联合谷氨酰胺进行治疗,记录两组患者治疗前后肠功能评分与APACHEⅡ评分变化情况,并且评估两组患者疗效。结果:两组患者治疗前,肠功能评分对比后无显著差异存在(P>0.05):两组患者治疗后,肠功能评分均有下降趋势,但两组患者对比,观察组下降趋势较对照组显著[(1.21±0.57)分<(1.97±0.58)分].组间数据差异显著(t=2.51,P<0.05)。同时,经治疗后对照组总有效例数为36例,观察组总有效例数为43例,对比两组总有效率,发现观察组优于对照组(95.56%>80.00%),组间数据差异显著(χ~2=5.07,P<0.05)。两组患者治疗前,APACHE-Ⅱ评分均无显著差异(P>0.05);两组患者治疗后,APACHE-Ⅱ评分均有下降趋势,但两组患者对比,观察组下降趋势较对照组显著[(11.40±0.34)分<(15.76±0.25)分],组间数据差异显著(t=32.55.P<0.05)。结论:在危重症感染合并胃肠道功能障碍患者的治疗中,应用谷氨酰胺治疗对患者胃肠功能具有改善的作用,临床应大力推广与运用。

Objective:To investigate the clinical efficacy of glutamine in the treatment of severe infection with gastrointestinal dysfunction.Methods:90 patients with severe infection and gastrointestinal disorders(from April 2017 to April 2018)were divided into two groups by drawing lots.The patients were added to the control group or the observation group according to the result of drawing lots.45 patients in the control group received routine treatment only,and 45 patients in the observation group were treated with glutamine on the basis of the control group.The intestinal function scores and APACHEⅡwere recorded before and after treatment in both groups.The changes were assessed and the efficacy of the two groups was evaluated.Results:Before and after treatment,there was no significant difference in intestinal function score between the two groups(P>0.05).The decreasing trend of the observation group was(1.21±0.57),which was more significant than the control group(1.97±0.58),and the difference between the two groups was significant(P<0.05).At the same time,the total effective cases in the control group and the observation group were 36 and 43,respectively.The comparison of the total effective rate between the two groups showed that the observation group was superior to the control group in the total effective rate of 95.56%.There was significant difference between the two groups(χ2=5.07,P<0.05).There was no significant difference in Apache E-Ⅱscore between the two groups before treatment(P>0.05),and there was a downward trend in Apache E-Ⅱscore after treatment in both groups,but the decreasing trend in the observation group was significantly lower than that in the control group[(11.40±0.34)<(15.76±0.25),P<0.05],and the difference between the two groups was significant(t=32.55,P<0.05).Conclusion:In the treatment of patients with severe infection complicated with gastrointestinal dysfunction,glutamine therapy can be used to treat patients with gastrointestinal dysfunction.Gastrointestinal function has the function of improvement,and should be popularized and applied in clinic.