胃肠减压联合保留灌肠治疗急性胰腺炎并发麻痹性肠梗阻的效果及对患者胃肠激素水平的影响

Effect of Gastrointestinal Decompression Combined with Retention Enema on Acute Pancreatitis Complicated with Paralytic Ileus and its Effect on Gastrointestinal Hormone Levels in Patients

目的探究胃肠减压联合保留灌肠治疗急性胰腺炎并发麻痹性肠梗阻的临床效果及对胃肠激素水平的影响。方法选择2020年1月-2021年6月于我院治疗的40例急性胰腺炎并发麻痹性肠梗阻患者作为研究对象。根据随机数字表法分为对照组(20例)和观察组(20例);对照组采用保留灌肠治疗,观察组采用胃肠减压联合保留灌肠治疗。比较两组肠功能恢复、胃肠激素[促胃液素(GAS)、胃动素(MOT)、胃蛋白酶原Ⅰ(PGⅠ)及胃蛋白酶原Ⅱ(PGⅡ)]水平、转手术或ICU治疗人数及并发症发生率。结果观察组腹胀缓解时间、肠鸣音恢复时间、排气时间短于对照组,差异有统计学意义(P<0.05);观察组转手术、ICU人数低于对照组,但差异无统计学意义(P>0.05);两组并发症比较,差异无统计学意义(P>0.05);观察组GAS、MOT、PGⅠ及PGⅡ水平均高于对照组,差异有统计学意义(P<0.05)。结论胃肠减压联合保留灌肠治疗可以提高急性胰腺炎并发麻痹性肠梗阻患者的临床效果,加快患者肠功能恢复,促进胃肠激素水平升高,且不增加并发症,安全性良好。

Objective To explore the clinical effect of gastrointestinal decompression combined with retention enema in the treatment of acute pancreatitis complicated with paralytic ileus and its effect on gastrointestinal hormone levels.Methods A total of 40 patients with acute pancreatitis complicated with paralytic intestinal obstruction treated in our hospital from January 2020 to June 2021 were selected as the research objects.According to the random number table method,they were divided into control group(20 cases)and observation group(20 cases).The control group was treated with retention enema,and the observation group was treated with gastrointestinal decompression combined with retention enema.The recovery of intestinal function,the levels of gastrointestinal hormones[gastrin(GAS),motilin(MOT),pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ)],the number of patients transferred to surgery or ICU and the incidence of complications were compared between the two groups.Results The abdominal distension relief time,bowel sound recovery time and exhaust time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The number of transferred to surgery and ICU in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).There was no significant difference in complications between the two groups(P>0.05).The levels of GAS,MOT,PGⅠand PGⅡin the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Gastrointestinal decompression combined with retention enema can improve the clinical effect of patients with acute pancreatitis complicated with paralytic ileus,accelerate the recovery of intestinal function,promote the increase of gastrointestinal hormone levels,and do not increase complications,with good safety.