加味大柴胡汤联合常规治疗对中度重症急性胰腺炎腹腔内高压的疗效研究  

Study on the curative effect of the modified Dachaihu decoction combined with conventional therapy on intra⁃abdominal hypertension in moderately severe acute pancreatitis

作　　者：高华[1] 聂锦山[1] Gao Hua;Nie Jinshan(Department of Gastroenterology,Taicang Hospital Affiliated to Suzhou University,Taicang 215400,China)

机构地区：[1]苏州大学附属太仓医院(太仓市第一人民医院)消化内科,江苏太仓215400

出　　处：《海军医学杂志》2021年第6期736-739,共4页Journal of Navy Medicine

基　　金：苏州市2018年度科技发展计划(民生科技——医疗卫生应用基础研究〔第二批〕)(SYSD2018037)。

摘　　要：目的观察加味大柴胡汤联合常规治疗对中度重症急性胰腺炎腹腔内高压的疗效。方法将太仓市第一人民医院消化内科收治的150例中度重症急性胰腺炎患者随机分为对照组与治疗组,各75例。对照组给予急性胰腺炎的常规治疗。治疗组予以常规治疗联合加味大柴胡汤治疗。动态监测2组患者腹内压变化,观察和记录排便时间、腹痛消失时间、腹胀消失时间、肠鸣音恢复时间及住院时间。结果2组患者平均腹内压随排便后均逐渐下降,治疗组腹腔内压下降速度明显快于对照组(P<0.05)。治疗组未进展至腹腔间隔室综合征(ACS)。治疗组患者的排便时间、腹痛消失时间、腹胀消失时间、肠鸣音恢复时间及住院时间均优于对照组,差异均有统计学意义(P<0.05)。结论加味大柴胡汤联合常规治疗中度重症急性胰腺炎,能够更有效地降低腹腔内高压,预防ACS及重症急性胰腺炎(SAP)的发生。Objective To observe the effect of the modified Dachaihu decoction combined with conventional treatment on in⁃tra⁃abdominal hypertension(IAH)in moderate severe acute pancreatitis(MSAP).Methods 150 patients with moderate severe acute pancreatitis admitted into the Taicang First Hospital were randomly divided into the control group and the treatment group,each consis⁃ting of 75 patients.The control group was given routine treatment of acute pancreatitis,while the treatment group was treated with rou⁃tine treatment combined with the modified Dachaihu decoction.Changes in intra⁃abdominal pressure were dynamically monitored,and the anal defecation time,the disappearance time of abdominal pain,the disappearance time of abdominal distension,the recovery time of bowel sounds and the length of hospital stay were observed and recorded in the patients of the 2 groups.Results The average intra⁃abdominal pressure of the 2 groups all decreased gradually after anal defecation,with that of the treatment group being obviously faster than that of the control group(P<0.05).Progression into abdominal compartment syndrome(ACS)was not seen in the treatment group.The abdominal distension,the disappearance time of abdominal pain,the disappearance time of abdominal distention,the recovery time of bowel sounds and the length of hospital stay of the treatment group were markedly superior than those of the control group(P<0.05).Conclusion The modified Dachaihu decoction combined with conventional therapy in treatment of moderate severe acute pancreatitis could more effectively reduce intra⁃abdominal high pressure and prevent occurrence of ACS and severe acute pancreatitis(SAP).

关 键 词：中度重症急性胰腺炎 加味大柴胡汤 腹腔内高压 

分 类 号：R657.[医药卫生—外科学]