芒硝腹部热敷袋在急性胰腺炎治疗中的应用  

The clinical application of mirabilite abdominal hot compression bag for treating acute pancreatitis

作　　者：赵艳梅[1] 菅志远[1] 

机构地区：[1]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,湖北十堰442000

出　　处：《中华胰腺病杂志》2016年第5期320-325,共6页Chinese Journal of Pancreatology

基　　金：湖北省教育厅重点项目（D20152103）;十堰市科技局计划项目（2011064）

摘　　要：目的：探讨自行设计制作的芒硝腹部热敷袋在中度重症急性胰腺炎（ MSAP）和重症急性胰腺炎（ SAP）治疗中的临床应用价值。方法收集70例MSAP和SAP患者，按照入院先后顺序分成观察组和对照组，每组35例。两组患者均采用常规治疗，观察组应用自行设计制作的芒硝腹部热敷袋腹部热敷，对照组采用传统的芒硝腹部外敷方法。记录两组患者入院1、3、6、9 d的APACHEⅡ评分，血清CRP、IL-1、IL-6、TNF-α水平，腹腔内高压（ IAH）及其他并发症（胰腺假性囊肿和肺部感染）的发生率，肠道功能恢复时间及平均住院天数，并分析两组中MSAP和SAP的治疗效果。结果两组患者入院1 d的APACHEⅡ评分及血清 CRP、IL-1、IL-6、TNF-α水平的差异均无统计学意义；入院3 d观察组的APACHEⅡ评分及CRP、IL-1、TNF-α水平显著低于对照组；入院6 d观察组的APACHEⅡ评分及CRP、IL-1、IL-6、TNF-α水平显著低于对照组；入院9 d观察组血清IL-1、TNF-α水平显著低于对照组，差异均有统计学意义（P值＜0．05或＜0．01）。观察组中4例（11．4％）发生IAH，7例（20．0％）发生其他并发症，肠道功能恢复时间为（4．9±0．8）d，平均住院时间为（13．1±2．1）d；对照组患者分别为11例（31．4％），10例（28．6％），（5．5±0．8）d，（15．4±3．9）d。观察组的IAH发生率显著低于对照组，肠道功能恢复时间及平均住院天数显著短于对照组，差异均有统计学意义（P值＜0．05或＜0．01），而两组其他并发症发生率的差异无统计学意义。观察组MSAP患者的肠道功能恢复时间及平均住院天数显著短于对照组，差异均有统计学意义[（5．0±0．8） d 比（5．5±0．8） d，P＝0．030；（12．7±1．7） d 比（15．2±3．6） d， P＝0．002]；而两组SAP患者各指标的差异均无统计学意义。结论芒硝腹部热敷袋腹部热敷可减轻MSAP和SAObjective To explore the clinical application of mirabilite abdominal hot compression bag designed by ourselves for the moderately severe acute pancreatitis （ MSAP ） or severe acute pancreatitis （ SAP） .Methods Seventy MSAP and SAP patients were randomly divided into the observed and control groups according to the admission date.Each group included 35 patients.All the patients received the routine treatment.The patients in observed group received the treatment of compression action on abdomen by mirabilite abdominal continual hot compression bag designed by ourselves, while the traditional mirabilite hot compression action was used in the control group.The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αof all patients on the 1st, 3rd, 6th, and 9th day after being admitted, the rate of complications including the intra-abdominal hypertension （IAH）, pancreatic pseudocysts （PPC） and pulmonary infection, the recovery time of intestinal function and mean hospitalization time were all recorded and the therapeuticefficacy was compared between the two groups.Furthermore, the therapeutic effects of MSAP and SAP were compared between two groups.Results The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αwere not statistically different between the two groups on the 1st day after hospitalization.The APACHEⅡscore and the levels of plasma CRP, IL-1 and TNF-αon the 3rd day in the observed group were significantly lower than those in the control group（P〈0.05 or 〈0.01）.The APACHEⅡ score and the levels of plasma CRP, IL-1 , IL-6 and TNF-αon the 6th day in the observed group were significantly lower, comparing to those in the control group.The levels of serum IL-1 and TNF-αin the observed groups were significantly lower than those in control group on the 9th day.All the differences above were statistically significant （ P〈0.05 or 〈0.01）.In the observed group, 4 cases （11.4%） had IAH and 7 cases （20.0%） developed other complications.The time of int

关 键 词：胰腺炎 芒硝 腹部 热敷袋 

分 类 号：R576[医药卫生—消化系统]