超声引导下空肠置管术联合中药对急性胰腺炎早期胃肠功能、血清炎性因子及SAS/SDS评分影响  

Effects of Ultrasound - Guided Jejunal Catheterization Combined with Traditional Chinese Medicine on Early Gastrointestinal Function Serum Inflammatory Factors and SAS/SDS Scores in Patients with Acute Pancreatitis

作　　者：荆治 李瑛琪 晁辉 姚宏军 王锐 柴常运 JING Zhi;LI Yingqi;CHAO Hui;YAO Hongjun;WANG Rui;CHAI Changyun(Yuncheng Center Hospital,Yuncheng 044000,Shanxi,China)

机构地区：[1]运城市中心医院,山西运城044000

出　　处：《中华中医药学刊》2022年第6期251-254,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：山西省卫生健康委项目(2019162)。

摘　　要：目的评价超声引导下空肠置管术联合中药对急性胰腺炎患者的短期疗效及情绪状态影响。方法研究为开放性、随机、平行对照、单中心研究。选取101例急性胰腺炎患者作为研究对象,随机分为联合组60例,对照组41例。两组均予急性胰腺炎常规治疗,对照组予以深静脉置管补充营养,联合组予以超声引导下经鼻空肠置管,同时注入中药大黄,外敷中药芒硝。评价两组患者治疗7 d后的早期胃肠功能恢复情况、血清炎症因子、淀粉酶恢复情况及SAS/SDS评分。结果①治疗7 d后,联合组患者的首次排便时间、腹痛缓解时间及腹胀缓解时间、血清淀粉酶及尿淀粉酶恢复时间明显短于对照组(P<0.01);②治疗7 d后,两组肿瘤因子-α(TNF-α)、白介素-6(IL-6)及白介素8(IL-8)较治疗前均有明显下降(P<0.05),且联合组的下降程度更显著(P<0.01);③治疗7 d后,两组患者的SAS/SDS评分均明显下降(P<0.05),且联合组的下降程度更明显(P<0.01)。结论超声引导经鼻空肠置管联合中药大黄及芒硝可明显缩短急性胰腺炎患者的早期胃肠功能恢复时间,降低血清炎症因子水平,改善不良情绪,短期疗效较好。Objective To evaluate the short-term efficacy and emotional state of ultrasound-guided jejunal catheterization combined with traditional Chinese medicine in patients with acute pancreatitis.Methods This study was an open,randomized,parallel control,single center study.A total of 101 patients with acute pancreatitis were selected and randomly divided into the combined group(60 cases)and the control group(41 cases).The two groups were treated with conventional treatment of acute pancreatitis.The control group was given deep vein catheterization for nutrition,and the combined group was given nasojejunal catheterization under ultrasound guidance.Meanwhile,Dahuang(rhubarb)was injected and Mangxiao(mirabilite)was applied.The recovery of early gastrointestinal function,serum inflammatory factors,amylase and SAS/SDS scores in two groups after 7 days of treatment were evaluated.Results①After 7 days of treatment,the first defecation time,the relief time of abdominal pain and abdominal distension,the recovery time of serum amylase and urinary amylase in the combined group were significantly shorter than those in the control group(P<0.01).②After 7 days of treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in both groups were significantly decreased compared with those before treatment(P<0.05),and the degree of decrease in the combined group was more significant(P<0.01).③After 7 days of treatment,SAS/SDS scores in both groups were significantly decreased(P<0.05),and the degree of decrease was more obvious in the combined group(P<0.01).Conclusion Ultrasound-guided nasojejunal catheter combined with Dahuang(rhubarb)and Mangxiao(mirabilite)can significantly shorten the recovery time of early gastrointestinal function in patients with acute pancreatitis,reduce the levels of serum inflammatory factors,improve the adverse mood and have good short-term efficacy.

关 键 词：急性胰腺炎 胃肠功能 炎症因子 大黄 芒硝 

分 类 号：R269.575.1[医药卫生—中西医结合]