改良保留灌肠术应用于急性胰腺炎合并麻痹性肠梗阻患者的效果

Effect of Modified Retention Enema in Patients with Acute Pancreatitis Complicated with Paralytic Ileus

目的:探讨改良保留灌肠术应用于急性胰腺炎合并麻痹性肠梗阻(PI)患者的效果。方法:将南方医科大学深圳医院2020年3月-2021年3月收治的88例急性胰腺炎合并PI患者分组,按照随机数字表法分为两组。对照组44例,给予传统保留灌肠干预,观察组44例给予改良保留灌肠术干预,观察两组疼痛、灌肠相关情况、炎症水平、症状恢复时间。结果:灌肠后,观察组胃肠道症状评定量表(GSRS)分值高于对照组,视觉模拟评分法(VAS)分值低于对照组(P<0.05);观察组PI缓解时间早于对照组,药物保留时间长于对照组,总灌肠次数少于对照组(P<0.05);观察组白细胞(WBC)、血清淀粉酶(AMS)、C反应蛋白、肌酸磷酸激酶(CPK)、白介素-6、肿瘤坏死因子-α(TNF-α)值均低于对照组(P<0.05);观察组腹胀腹痛缓解时间、体温恢复时间、自行排便时间均早于对照组(P<0.05)。结论:改良保留灌肠术应用于急性胰腺炎合并PI患者可有效降低疼痛度,改善灌肠相关情况,减轻炎症反应,促进症状消退。

Objective:To investigate the effect of modified retention enema in patients with acute pancreatitis complicated with paralytic ileus(PI).Method:A total of 88 patients with acute pancreatitis complicated with PI in Shenzhen Hospital of Southern Medical University from March 2020 to March 2021 were divided into two groups according to the random number table method.A total of 44 patients in the control group were given traditional retention enema intervention,and 44 patients in the observation group were given modified retention enema intervention.The pain,enema related conditions,inflammation level and symptom recovery time of the two groups were observed.Result:After enema,the score of gastrointestinal symptom rating scale(GSRS)in the observation group was higher than that in the control group,and the score of visual analogue scale(VAS)was lower than that in the control group(P<0.05).The remission time of PI in the observation group was earlier than that in the control group,the drug retention time was longer,and the total number of enemas was less than that in the control group(P<0.05).The white blood cells(WBC),serum amylase(AMS),C-reactive protein,creatine phosphokinase(CPK),interleukin-6 and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).The relief time of abdominal distension and abdominal pain,temperature recovery time and the self defecation in the observation group were earlier than those in the control group(P<0.05).Conclusion:Modified retention enema for patients with acute pancreatitis complicated with PI can effectively reduce pain,improve enema related conditions,reduce inflammatory reaction and promote the regression of symptoms.