奥曲肽联合生大黄灌肠对急性胰腺炎合并腹腔高压患者腹内压及血清炎症因子的影响

Effects of Octreotide Combined with Unprocessed Dahuang on Intra-abdominal Pressure and Serum Inflammatory Factors in Patients with Acute Pancreatitis Complicated with Abdominal Hypertension

目的:探讨奥曲肽联合生大黄灌肠对急性胰腺炎合并腹腔高压患者腹内压及血清炎症因子的影响。方法:前瞻性选取2021年8月—2023年8月大连大学附属中山医院收治的98例急性胰腺炎合并腹腔高压患者,采用随机数字表法分为对照组和联合组,每组49例。两组均给予常规治疗,对照组给予奥曲肽治疗,联合组在对照组基础上给予生大黄灌肠治疗。观察患者腹内压变化情况,记录病理生理指标及住院时间,统计不良事件发生情况,对比治疗前后两组血清炎症因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及超敏C反应蛋白(hs-CRP)]水平。结果:两组治疗1、3、5、7 d后的腹内压均低于治疗前,且联合组治疗3、5 d后的腹内压均低于对照组,差异均有统计学意义(P<0.05)。联合组主要症状和阳性体征消失时间均早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。联合组治疗后急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分低于对照组,差异有统计学意义(P<0.05)。联合组治疗后血清IL-6、TNF-α及hs-CRP水平均低于对照组,差异均有统计学意义(P<0.05)。两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论:奥曲肽联合生大黄灌肠对急性胰腺炎合并腹腔高压患者进行治疗,可降低患者腹内压,缩短主要症状、阳性体征持续时间及住院时间,降低炎症因子水平,安全性高。

Objective:To investigate the effects of Octreotide combined with unprocessed Dahuang on intra-abdominal pressure and serum inflammatory factors in patients with acute pancreatitis complicated with abdominal hypertension.Method:A total of 98 patients with acute pancreatitis complicated with abdominal hypertension admitted to Affiliated Zhongshan Hospital of Dalian University from August 2021 to August 2023 were prospectively selected and divided into control group and combined group by random number table method,with 49 cases in each group.Both groups were given conventional treatment,the control group was given Octreotide treatment,and the combined group was given unprocessed Dahuang treatment on the basis of the control group.The changes of patients'intra-abdominal pressure were observed,the pathophysiological indexes and hospital stay were recorded,the occurrence of adverse events were statistically analyzed,and the levels of serum inflammatory factors[interleukin-6(IL-6),tumor necrosis faction-α(TNF-α)and hypersensitive C reactive protein(hs-CRP)]before and after treatment were compared between the two groups.Result:The intra-abdominal pressure of the two groups after 1,3,5 and 7 d of treatment were lower than those before treatment,and those in the combined group after 3 and 5 d of treatment were lower than those in the control group,the differences were statistically significant(P<0.05).The disappearance time of the main symptoms and positive signs in the combined group were earlier than those in control group,hospital stay in the combined group was shorter than that in the control group,the differences were statistically significant(P<0.05).The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score of combined group after treatment was lower than that of control group,the difference was statistically significant(P<0.05).The levels of serum IL-6,TNF-αand hs-CRP in combined group after treatment were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion:Octreotide combined with unprocessed Dahuang in the treatment of patients with acute pancreatitis complicated with abdominal hypertension can reduce the intra-abdominal pressure of patients,shorten the duration of main symptoms and positive signs and hospital stay,reduce the levels of inflammatory factors,and have high safety.