不同胃管置入长度对急性胰腺炎患者症状改善及康复预后的影响  

Impact of different insertion length of gastric tube on symptoms improvement and rehabilitation prognosis in patients with acute pancreatitis

作　　者：袁晓燕[1,2] 凌云 王华 顾永峰 何小雪 郭东风 

机构地区：[1]上海浦东新区公利医院急诊科,上海200135 [2]宁夏医科大学,宁夏银川750004 [3]上海浦东新区公利医院检验科,上海200135

出　　处：《海南医学》2017年第10期1565-1568,共4页Hainan Medical Journal

基　　金：上海市浦东新区重点学科群资助(编号:PWZxq2014-09)

摘　　要：目的研究不同胃管置入长度对急性胰腺炎患者症状改善及康复预后的影响。方法选择2015年1月至2016年9月在我院急诊科进行治疗的110例急性胰腺炎患者,依据简单数字随机表法将患者分为观察组和对照组,每组55例,两组患者均给予禁食和胃肠减压,以及调节机体内的酸碱平衡及水电解质平衡等急诊对症治疗,同时应用胰腺分泌抑制类药物及质子泵抑制剂进行治疗。对照组通过常规方式置入胃管,观察组给予适当增长的胃管置入长度方式,比较两组患者的腹痛缓解时间、血淀粉酶恢复至正常时间、留置胃管时间及住院时间、并发症,治疗前及治疗7 d后的降钙素原(PCT)、血清淀粉酶(AMY)及尿淀粉酶(UAMY)水平以及疼痛情况。结果观察组患者的腹痛缓解时间[(24.52±2.34)h]、血淀粉酶恢复至正常时间[(3.28±0.63)d]、留置胃管时间[(4.22±0.84)d]及住院时间[(6.58±0.62)d]均明显少于对照组[(35.87±1.62)d、(5.17±1.21)d、(6.87±1.30)d及(10.17±1.84)d],差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为9.09%,明显低于对照组的23.64%,差异有统计学意义(P<0.05);治疗后,两组患者的PCT、AMY及UAMY水平明显低于治疗前,且观察组的PCT[(0.29±0.14)ng/mL]、AMY[(45.84±13.38)U/L]及UAMY水平[(189.28±58.32)U/L]明显低于对照组[(0.45±0.20)ng/mL、(57.64±12.21)U/L及(223.48±49.47)U/L],差异均有统计学意义(P<0.05);治疗后,两组患者的疼痛视觉模拟评分(VAS)均明显低于治疗前,且观察组的VAS评分为(1.03±0.22)分,明显低于对照组的(1.59±0.17)分,差异均有统计学意义(P<0.05)。结论适当地增加胃管置入的长度有利于患者机体症状的改善,促进其获得更好的康复预后,安全性较好,值得推广。Objective To study impact of different insertion length of gastric tube on the symptoms improve-ment and rehabilitation prognosis in patients with acute pancreatitis. Methods A total of 110 patients with acute pancre-atitis who were treated in the Emergency Department, Gongli Hospital of Shanghai Pudong New Area from January 2015 to September 2016 were enrolled in this study. The patients were divided into the observation group and the control group according to the simple digital random table method, with 55 cases in each group. Emergency symptomatic treat-ment such as fasting and gastrointestinal decompression, regulating the body＇s acid-base balance and water electrolyte balance as well as the use of pancreatic secretion inhibition drugs and proton pump inhibitor drugs were given to the pa-tients in two groups. Gastric tube was inserted into the stomach of patients in the control group in the conventional way, but in the way of increasing the approciate insertion length of gastric tube in the observation group. Comparison was made between two groups, which involved relief time of abdominal pain, restoring time of blood amylase to normal, in-dwelling time of gastric tube, hospitalized time complications, procalcitonin （PCT）, serum amylase （AMY） and urine am-ylase （UAMY） before treatment and 7 d after treatment and pain condition. Results In the observation group, the relief time of abdominal pain （24.52±2.34） h, restoring time of blood amylase to normal （3.28±0.63） d, indwelling time of gas-tric tube （4.22±0.84） d and hospitalization time （6.58±0.62） d were significantly less than （35.87±1.62） d, （5.17±1.21） d, （6.87±1.30） d and （10.17±1.84） d] in the control group, all the differences being statistically significant （P〈0.05）. The to-tal incidence rate of complications in patients of the observation group was 9.09%, significantly lower than 23.64%in the control group, showing the difference was statistically significant （P〈0.05）. After treatment,

关 键 词：胃管置入长度 急性胰腺炎 症状改善 康复 预后 

分 类 号：R657.51[医药卫生—外科学]