早期超声引导下经皮穿刺置管引流联合“郭氏六联疗法”对急性胰腺炎患者的疗效与炎症因子的影响  

Effect of Early Ultrasound-guided Percutaneous Catheter Drainage Combined with Guo’s Six-joint Therapy on Curative Effect and Inflammatory Factors in Patients with Acute Pancreatitis

作　　者：林金锌 陈英杰 陈名智 郭森仁 郭静宜[2] LIN Jinxin;CHEN Yingjie;CHEN Mingzhi;GUO Senren;GUO Jingyi(Jinjiang Hospital of Traditional Chinese Medicine,Jinjiang 362200,China;不详)

机构地区：[1]福建省晋江市中医院,福建晋江362200 [2]福建省晋江市医院

出　　处：《中国医学创新》2021年第33期99-104,共6页Medical Innovation of China

基　　金：郭森仁全国基层名老中医药专家传承工作室建设项目(国中医药人教发[2016]41号);2016-2019年度福建省中医药科技项目(2017FJZYLC105)。

摘　　要：目的:探讨早期超声引导下经皮穿刺置管引流联合"郭氏六联疗法"对急性胰腺炎患者疗效与炎症因子的影响。方法:回顾性分析72例急性胰腺炎临床治疗经过,按照是否行早期超声引导下经皮穿刺置管引流分为观察组(n=40)和对照组(n=32)。对照组给予常规西医治疗联合"郭氏六联疗法",观察组在上述治疗的基础上行早期超声引导下经皮穿刺置管引流。比较两组腹胀及腹痛缓解时间、肛门首次排便时间、总住院时间,比较两组治疗前后血清TNF-α、IL-1β、IL-6、IL-8的变化,观察两组持续性器官功能衰竭(POF)和胰腺坏死组织感染(IPN)发生率的差异。结果:观察组腹胀及腹痛缓解时间、肛门首次排便时间、总住院时间均明显短于对照组(P<0.05)。观察组治疗后POF和IPN发生率均明显低于对照组(P<0.05)。两组治疗前血清炎症因子水平比较,差异均无统计学意义(P>0.05);治疗后72 h、1周,两组血清TNF-α、IL-1β、IL-6、IL-8水平均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:采用早期超声引导下经皮穿刺置管引流联合"郭氏六联疗法"治疗急性胰腺炎,可以明显降低患者肠麻痹时间,减轻炎症反应,减少POF和IPN发生率,缩短住院时间,临床效果显著。Objective:To investigate the effect of early ultrasound-guided percutaneous catheter drainage combined with Guo’s six-joint therapy on curative effect and inflammatory factors in patients with acute pancreatitis.Method:The clinical treatment of 72 patients with acute pancreatitis were analyzed retrospectively,according to whether early ultrasound-guided percutaneous catheter drainage was performed,the subjects were divided into the observation group(n=40)and the control group(n=32).The control group was treated with routine western medicine combined with Guo’s six-joint therapy,and the observation group was treated with early ultrasound-guided percutaneous catheterization on the basis of the control group.The times of abdominal distension and abdominal pain relief,the first anal defecation time and the total hospitalization time were compared between two groups,the changes of serum TNF-α,IL-1β,IL-6 and IL-8 of two groups before and after treatment were analyzed,the differences in persistent organ failure(POF)incidence and infected pancreatic necrosis(IPN)were observed between two groups.Result:The time of abdominal pain and abdominal distension relief,the first anal defecation time and the total hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).The incidences of POF and IPN in the observation group were significantly shorter than those in the control group(P<0.05).There were no significant differences in serum inflammatory factors in two groups before treatment(P>0.05);72 h and 1 week after treatment,serum TNF-α,IL-1β,IL-6 and IL-8 in two groups decreased,and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Early ultrasound-guided percutaneous catheter drainage combined with Guo’s six-joint therapy in the treatment of acute pancreatitis can significantly reduce the time of intestinal paralysis,the inflammatory reaction and the incidences of POF and IPN,shorten

关 键 词：超声引导 经皮穿刺置管引流 郭氏六联疗法 急性胰腺炎 炎症因子 

分 类 号：R576[医药卫生—消化系统]