芒硝热敷袋腹部热敷在重症急性胰腺炎治疗中的应用价值  

Application effect of abdomen hot compression of the mirabilite hot compression bag on the treatment of severe acute pancreatitis

作　　者：赵艳梅[1] 营志远 王好[1] 李慧丽[1] 李玲[1] Zhao Yanmei Jian Zhiyuan Wang Hao Li Huili Li Ling(Hepatopancreatobiliary Surgery Center, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan 442000, Chin)

机构地区：[1]湖北省十堰市太和医院湖北医药学院附属医院肝胆胰外科诊疗中心,442000

出　　处：《中华现代护理杂志》2016年第25期3636-3640,共5页Chinese Journal of Modern Nursing

摘　　要：目的：探讨自行设计制作的芒硝热敷袋在重症急性胰腺炎治疗中的应用效果。方法将湖北省十堰市太和医院（湖北医药学院附属医院）肝胆胰中心2013年6月—2016年2月收治的70例重症急性胰腺炎患者，根据诊治先后顺序进行分组，分别分为对照组和观察组各35例，两组患者在常规治疗的基础上，对照组采用传统方法芒硝腹部外敷，观察组应用自行设计制作的芒硝热敷袋腹部热敷；比较两组患者入院第1，3，6，9天的急性生理与慢性健康状况评分Ⅱ（ APACHE Ⅱ）评分和血清炎性因子浓度，并观察两组患者腹腔内高压的发生率、肠道功能恢复时间及平均住院日。结果两组患者住院1d时的APACHE Ⅱ评分、血清C反应蛋白（CRP）、白细胞介素－1（IL-1）、白细胞介素－6（IL-6）及肿瘤坏死因子（TNF）的浓度差异无统计学意义（P〉0.05）；入院后第3天，观察组患者的APACHE Ⅱ评分、血清CRP、IL-1及TNF的浓度低于对照组（P〈0.05）；入院后第6天，观察组患者的 APACHEⅡ评分、血清CRP、IL-1、IL-6及TNF的浓度均低于对照组（ P〈0.01）；第9天时，观察组患者的血清IL-1、TNF的浓度低于对照组（P〈0.01）。观察组中有4例腹腔压力〉12 cm H2O，对照组11例，差异有统计学意义（χ2＝4.158，P＝0.041）；观察组和对照组患者的肠道功能恢复时间分别为（4.9±0.8），（5.5±0.8）d，平均住院时间为（13.1±2.1），（15.4±3.9）d，差异有统计学意义（t值分别为2.899，3.129；P〈0.05）。结论芒硝热敷袋热敷可促进重症急性胰腺炎患者的肠道功能恢复，降低血清CRP、IL-1、IL-6及TNF浓度，降低腹腔内高压的发生率并缩短住院时间。Objective To observe the application effect of the self-designed mirabilite hot compression bag on the treatment of severe acute pancreatitis.Methods Seventy severe acute pancreatitis patients who were treated in Hepatopancreatobiliary Surgery Center, Taihe Hospital Affiliated with Hubei University of Medicinein the city of Shiyan in Hubei Province from June of 2013 to February of 2016 were randomly divided into the controlgroup （n=35） and the observation group （n=35） based on the sequence of diagnosis and treatment. Besides the conventional treatment, the patients in the control group received the conventional external application of mirabilite on the abdomen, while the patients in the observation group received abdomen hot compression of the self-designed mirabilite hot compression bag. The acute physiology and chronic health evaluation Ⅱ （ APACHEⅡ） score and the concentrations of seruminflammatory cytokines on the 1st, 3rd, 6th, 9th day after the admission were compared between the two groups. The incidence rate of the high intra-abdominal pressure, the recovery time of intestinal function andthe average length of stay were analyzed and compared between the two groups. Results On the 1st day after the admission theAPACHE Ⅱ score, the concentrations of C-reactive protein （CRP）, interleukin-1（IL-1）, interleukin-6 （IL-6） and tumor necrosis factor （TNF）in the serum were not significantly different between the two groups （P〉0.05）. On the 3rd day after the admission, the APACHE Ⅱ score, the concentrations of CRP, IL-1 and TNF in the serum in the observation group were significantly lower compared to the control group （P〈0.05）. On the 6th day after the admission, the APACHE Ⅱ score, the concentrations of CRP, IL-1, IL-6 and TNF in the serum in the observation group were significantly lower compared to the control group （P〈0.01）. On the 9th day after the admission, the concentrations of IL-1, TNF in the serum in the observation group were significantly lower comp

关 键 词：重症急性胰腺炎 中医护理 芒硝热敷袋 

分 类 号：R473.5[医药卫生—护理学]