体表胃肠起搏治疗对重症急性胰腺炎肠道屏障功能的影响  

Effects of surface gastrointestinal pacing therapy on intestinal barrier function in severe acute pancreatitis

作　　者：陈腾千 蒋义贵 张生君 姜丽华 胡永敏 尤丽财 Chen Tengqian;Jiang Yigui;Zhang Shengjun;Jiang Lihua;Hu Yongmin;You Licai(Department of Gastroenterology,the First Hospital of Sanrning,Fujian Medical University,San ruing 365000,China)

机构地区：[1]福建医科大学附属三明第一医院消化内科,福建三明365000

出　　处：《临床荟萃》2018年第9期783-786,共4页Clinical Focus

摘　　要：目的观察在重症急性胰腺炎(SAP)患者中使用体表胃肠起搏治疗对肠道屏障功能的影响。方法 47例SAP患者分为对照组(22例)和试验组(25例),其中试验组是在对照组包括禁食、胃肠减压、抗感染、抗炎(乌司他汀)、抑制胃酸分泌(奥美拉唑)、生长抑素(注射用生长抑素)等常规治疗基础上加用体表胃肠起搏治疗。在治疗前及治疗24、48和96小时分别对2组肠鸣音次数及血浆内毒素和D-乳酸、血清二胺氧化酶(DAO)水平进行监测,并观察治疗24、48和96小时2组腹痛、腹胀症状消失例数。结果 2组治疗24、48和96小时内毒素、D-乳酸和DAO水平均较治疗前明显下降(均P <0.05),治疗48、96小时肠鸣音次数均较前增加(均P <0.05);2组治疗24、48小时肠鸣音次数及内毒素、D-乳酸和DAO水平比较差异均无统计学意义(均P>0.05);试验组与对照组对比,治疗96小时肠鸣音次数、腹痛和腹胀症状消失例数均明显增加,内毒素、D-乳酸和DAO水平均明显下降(均P <0.05)。结论 SAP患者采用体表胃肠起搏治疗可以尽早恢复患者胃肠动力,进而改善胃肠屏障功能,减少内毒素的易位,防止出现肠功能衰竭,促进病情早期恢复,是一项简单的值得推广的辅助治疗措施。Objective To observe the effect of surface gastrointestinal pacing therapy on intestinal barrier function in patients with severe acute panereatitis （SAP）. Methods A total of 47 patients with SAP were divided into the control group （22 cases） and the experimental group （25 cases）. Apart （rom the treatment received by the control group, which included conventional treatment such as fasting, gastrointestinal decompression, anti infection, anti inflammatory （ulinastatin） , inhibition of gastric acid secretion （Omeprazole）, somatostatin （somatostatin injection）, patients in the experimental group also need to receive the treatment of surface gastrointestinal pacing therapy. The number of bowel sounds and plasma endotoxin, D-lactic acid, and serum diamine oxidase （DAO） levels were monitored respectively before the treatment and 24, 48, and 96 h after the treatment. The number of cases whose abdominal pain and abdominal distension had disappeared 24 , 48, and 96 h after the treatment was measured. Results The levels of endotoxin, D-lactic acid, and DAO in two groups 24, 48, and 96 h after the treatment were significantly lower than those before the treatment （ P 〈0.05）, and the number of bowel sounds increased 48 and 96 h after the treatment（all P 〈0.05）. There were no statistical significance between the two groups in terms of the comparison of frequencyo（ bowel sotmds and endotoxin, D-lactate and DAO 24 and 48 h a（ter the treatment （all P 〉0.05）. Compared with the control group, the number of patients in the experimental group with abdominal pain, abdominal distension and decreasing borborygmus increased significantly, and their levels of endotoxin, D lactic acid, and DAO significantly decreasedg 96 h after the treatment（allP 〈0. 05）. Conclusion The use of surface gastrointestinal pacing therapy in SAP patients can restore gastrointestinal motility as soon as possible, thereby improving gastrointestinal barrier function, reducing endotoxin translocation, preve

关 键 词：胰腺炎 肠道屏障功能 体表胃肠起搏治疗 胃肠动力障碍 

分 类 号：R576[医药卫生—消化系统]