大黄灌肠联合芒硝腹部外敷治疗重症急性胰腺炎伴腹胀临床研究  

Clinical Study on Enema with Rhei Radix et Rhizoma Combined with External Application at Abdomen with Natrii Sulfas for Severe Acute Pancreatitis Complicated with Abdominal Distension

作　　者：禹花 尹静 何汪涯 YU Hua;YIN Jing;HE Wangya

机构地区：[1]丽水市中心医院重症医学科,浙江丽水323000

出　　处：《新中医》2023年第12期171-176,共6页New Chinese Medicine

摘　　要：目的:观察大黄灌肠联合芒硝腹部外敷治疗重症急性胰腺炎(SAP)伴腹胀的临床疗效。方法:选取80例SAP伴腹胀患者,按随机数字表法分为研究组和对照组,每组40例。对照组给予常规西药对症治疗及护理干预,研究组在对照组基础上给予大黄灌肠联合芒硝腹部外敷治疗,2组均干预7 d。比较2组腹胀缓解、肠鸣音恢复、首次排便时间,心率(HR),氧合指数,急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)、改良CT严重指数(MCTSI)评分,腹内压(IAP),胃残余量,空腹胃窦收缩频率,肠鸣音频率,血清脂肪酶(LPS)、胰淀粉酶(PAMY)水平,以及不良反应发生率。结果:干预后,研究组腹胀缓解、肠鸣音恢复、首次排便时间均短于对照组(P<0.05)。2组HR,APACHEⅡ、MCTSI评分,IAP,胃残余量,血清LPS、PAMY水平均较干预前降低(P<0.05),研究组HR,APACHEⅡ、MCTSI评分,IAP,胃残余量,血清LPS、PAMY水平均低于对照组(P<0.05)。2组氧合指数、空腹胃窦收缩频率、肠鸣音频率均较干预前升高(P<0.05),研究组氧合指数、空腹胃窦收缩频率、肠鸣音频率均高于对照组(P<0.05)。治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:大黄灌肠联合芒硝腹部外敷治疗对SAP伴腹胀患者的胃肠道功能恢复具有积极作用,能有效缓解临床症状,安全性好。Objective:To observe the clinical effect of enema with Rhei Radix et Rhizoma combined with external application at abdomen with Natrii Sulfas for severe acute pancreatitis(SAP)complicated with abdominal distension.Methods:A total of 80 cases of patients with SAP complicated with abdominal distension were selected and divided into the study group and the control group according to the random number table method,with 40 cases in each group.The control group was given symptomatic treatment with routine western medicine and nursing intervention,and the study group was additionally treated with enema with Rhei Radix et Rhizoma combined with external application at abdomen with Natrii Sulfas based on the treatment of the control group.Both groups were intervened for 7 days.The remission time of abdominal distension,the recovery time of bowel sounds,the first defecation time,heart rate(HR),oxygenation index,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)and Modified CT Severity Index(MCTSI)scores,intra-abdominal pressure(IAP),gastric residual volume,fasting gastric antrum contraction frequency,bowel sound frequency,serum lipase(LPS)and pancreatic amylase(PAMY)levels,and the incidence of adverse reactions were compared between the two groups.Results:After intervention,the remission time of abdominal distension,the recovery time of bowel sounds,and the first defecation time in the study group were shorter than those in the control group(P<0.05).The scores of HR,APACHEⅡand MCTSI,IAP,gastric residual volume,serum LPS and PAMY levels in the two groups were lower than those before intervention(P<0.05),while HR,APACHEⅡand MCTSI scores,IAP,gastric residual volume,and serum LPS and PAMY levels in the study group were lower than those in the control group(P<0.05).The oxygenation indexes,fasting gastric antrum contraction frequency,and bowel sound frequency in the two groups were increased when compared with those before intervention(P<0.05),and the oxygenation index,fasting gastric antrum contraction frequency,an

关 键 词：重症急性胰腺炎 腹胀 大黄灌肠 芒硝腹部外敷 胃肠道功能 脂肪酶 胰淀粉酶 

分 类 号：R657.51[医药卫生—外科学] R244.9[医药卫生—临床医学]