聚氨基葡萄糖羧酸钠医用生物胶体液在急诊术后黏连性肠梗阻预防中的应用

Application of polyglucosamine sodium carboxylate medical biocolloid in the prevention of adhesive intestinal obstruction after emergency operation

目的探讨聚氨基葡萄糖羧酸钠医用生物胶体液在急诊术后黏连性肠梗阻预防中的应用效果。方法选取我院2017年1月至2019年3月收治的170例急诊术后患者,随机分为对照组和观察组,各85例,分别给予0.9%氯化钠溶液和聚氨基葡萄糖羧酸钠医用生物胶体液术中应用,比较两组术后黏连性肠梗阻发生率、术后首次排气时间、术后首次排便时间、术后腹胀缓解时间、术后住院时间及治疗前后炎性细胞因子水平。结果对照组和观察组术后黏连性肠梗阻发生率分别为22.35%、3.53%,观察组低于对照组(P<0.05)。对照组术后首次排气、首次排便、腹胀缓解及住院时间分别为(54.85±6.51)h、(54.85±6.51)h、(24.12±3.90)h、(16.93±2.42)d;观察组术后首次排气、首次排便、腹胀缓解及住院时间分别为(42.93±4.25)h、(50.17±6.52)h、(15.20±2.84)h、(12.03±1.87)d,观察组均短于对照组(P<0.05)。对照组治疗后48hPCT、CRP、TNF-α水平分别为(39.55±5.72)ng/L、(17.30±3.56)mg/L、(3.76±1.80)ng/L,观察组为(17.30±2.39)ng/L、(10.74±2.18)mg/L,(1.22±1.46)ng/L,观察组低于对照组及术前(P<0.05)。结论聚氨基葡萄糖羧酸钠医用生物胶体液用于急诊术后患者可有效降低黏连性肠梗阻发生风险,促进术后胃肠功能恢复,缩短住院时间,并有助于减轻机体炎症反应。

Objective To investigate the effects of polyglucosamine sodium carboxylate medical biocolloid in the prevention of adhesive intestinal obstruction after emergency operation. Methods Totally 170 patients with adhesive intestinal obstruction after emergency operation were chosen in the period from January 2017 to March 2019 in our hospital and randomly divided into 2 groups, including control group ( n = 85) given 0. 9% NaCl solution and observation group ( n = 85) given polyglucosamine sodium carboxylate medical biocolloid. The incidence of postoperative adhesive intestinal obstruction, time of exhaust after operation and defecation for first time after operation, time of relieving abdominal distension after operation, time of hospitalization after operation and the levels of inflammatory cytokines before and after operation of 2 groups were compared. Results The incidence of adhesive intestinal obstruction inobservation group waslower than that in control group ( 3. 53% vs. 22. 35%,P < 0. 05). The time of exhaust and defecation for the first time,time of relieving abdominal distension,and time of hospitalization after operation in control group were ( 54. 85 ± 6. 51) h,( 54. 85 ± 6. 51) h,( 24. 12 ± 3. 90) h and( 16. 93 ± 2. 42) d,respectively,and those in observation group were ( 42. 93 ± 4. 25) h,( 50. 17 ± 6. 52) h,( 15. 20 ± 2. 84) h and ( 12. 03 ± 1. 87) d,respectively. The above indexes of observation group were less than those of control group( P < 0. 05). The levels of PCT,CRP and TNF-α at 48 h after operation in control group were ( 39. 55 ± 5. 72) ng /L,( 17. 30 ± 3. 56) mg /L and ( 3. 76 ± 1. 80) ng /L,and they were ( 17. 30 ± 2. 39) ng /L,( 10. 74 ± 2. 18) mg /L and ( 1. 22 ± 1. 46) ng /L in observation group. The levels of PCT,CRP and TNF-α after operation in observation group were lower than those of control group ( P < 0. 05). Conclusion Polyglucosamine sodium carboxylate medical biocolloid on patients with adhesive intestinal obstruction after emergency operation can efficiently reduce the risk of adhesive intestinal obstruction,promote the recovery process of gastrointestinal function, shorten the hospital stay time and be helpful to alleviate inflammation.