不同时间导泻对重症急性胰腺炎的治疗作用

Therapeutic effect of early stage bowel catharsis on severe acute pancreatitis

目的 探讨不同时间导泻对重症急性胰腺炎 (SAP)的治疗作用。 方法 38例 SAP患者分为早期导泻 (发病 4 8h内 )与非早期导泻 (发病 4 8h后 )两组 ,观察腹胀缓解、肠鸣音恢复时间 ,血淀粉酶及血白细胞数恢复正常的时间 ,感染发生率 ,并发症发生率 ,死亡率等的差别。 结果 早期导泻治疗组其腹胀等腹部症状的缓解、肠鸣音的恢复明显优于非早期导泻治疗组 (P<0 .0 5 ) ,早期导泻治疗其继发感染率明显低于非早期导泻治疗 (P<0 .0 5 )。但血淀粉酶恢复正常时间无差异。早期导泻组其并发症发生率、死亡率少于非早期导泻组 ,但无统计学差异。 结论 早期导泻治疗有利于较早地缓解腹部症状 ,减少感染的发生率。

Objective To discuss the therapeutic effect of early stage bowel catharsis on severe acute pancreatitis (SAP). Methods 38 SAP cases were divided into two groups: early bowel catharsis (within 48 h of onset)group (group Ⅰ) and non early bowel catharsis (after 48 h of onset) group (group Ⅱ). Relief of abdominal distension,return of bowel sound,time of blood amylase and WBC count returning to normal levels,and incidences of infection,morbidity and mortality were compared between the two groups. Results Relief of abdominal distension and return of bowel sound were significantly better in group Ⅰ than in group Ⅱ ( P < 0.05).The incidence of secondary infection of group Ⅰ was significantly lower than that of group Ⅱ( P < 0.05). There was no significant difference in blood amylase change between the two groups. The morbidity and mortality of group Ⅰ were lower than those of group Ⅱ,though the differences were not statistically significant. Conclusions Early stage bowel catharsis is beneficial to relieving abdominal symptoms and reducing the incidence of infection in SAP.