超声下胃窦运动指数对新斯的明改善重型急性胰腺炎胃肠道功能疗效分析  

Effect of Neostigmine on Gastrointestinal Function of Severe Acute Pancreatitis

作　　者：郑圣斌 杨国华[1] 汪新财 ZHENG Sheng-bin;YANG Guo-hua;WANG Xin-cai(Department of General Surgery,Shengli Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital South Branch,Fuzhou 350000,China;Department of Critical Care Medicine,Shengli Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital South Branch,Fuzhou 350000,China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院南院普通外科),福建福州350000 [2]福建医科大学省立临床医学院(福建省立医院南院重症医学一科),福建福州350000

出　　处：《海峡药学》2023年第8期103-108,共6页Strait Pharmaceutical Journal

摘　　要：目的 探讨超声下胃窦运动指数对新斯的明改善重型急性胰腺炎胃肠道功能疗效分析。方法 回顾性分析福建省立医院南院自2019年1月至2021年12月收治的SAP患者75例,按照治疗方法不同分为观察组和对照组,其中对照组43例采用常规治疗方式,观察组32例在对照组基础上联合新斯的明治疗,比较两组治疗前后血清前白蛋白、血清淀粉酶、C-反应蛋白、改良CT严重指数(MCTSI)评分、Marshall评分、症状缓解时间、肠鸣音恢复正常时间、肠内营养达标时间、胃窦运动指数(MI)>0.8时间、ICU住院天数、死亡人数的区别,比较两组治疗过程中需升级有创机械通气和CRRT治疗的差异以及治疗过程中新发的器官功能障碍(心脏、肺部、循环、肝脏和肾脏)的差异。结果 治疗后观察组前白蛋白、胃窦运动指数比对照组升高,淀粉酶、腹内压、Marshall评分较对照组下降,差异具有统计学意义(P<0.05),C-反应蛋白和MCTSI评分观察组比对照组无显著下降,差异无统计学意义(P>0.05);观察组治疗过程中恶心、呕吐和腹胀缓解时间均短于对照组,差异具有统计学意义(P<0.05),而腹痛缓解时间两组差异具无统计学意义(P>0.05);观察组达到肠鸣音恢复正常时间、肠内营养达标时间(d)和MI>0.8时间均短于与对照组,差异具有统计学意义(P<0.05)。两组治疗过程中需升级有创机械通气和CRRT治疗病例数对比无统计学差异(P>0.05)。观察组新发的肾脏功能障碍少于对照组差异具有统计学意义(P<0.05),而新发心脏、肺部、循环和肝脏障碍两组相比无统计学差异(P>0.05)。两组死亡人数无统计学差异(P>0.05),观察组住院天数少于对照组,有统计学意义(P<0.05);当MI小于0.6时观察组治疗第1天和第14天腹内压和MI的呈负相关关系,相关系数(R值)分别为-0.88和-0.90(P<0.01)。结论 新斯的明可降低SAP患者的腹内压,缓解临床症状,缩短肠内营养达标�OBJECTIVE To investigate the effect of neostigmine on gastrointestinal function in patients with severe acute pancreatitis.METHODS 75 cases of SAP patients admitted to Our Hospital from January 2019 to December 2021 were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,43 cases in the control group received conventional treatment,32 cases in the observation group received neostigmine treatment on the basis of the control group.The differences of serum prealbumin,serum amylase,C-reactive protein,modified CT severity index(MCTSI)score,Marshall score,symptom relief time,bowel sound return to normal time,enteral nutrition standard time,MI>0.8 time,ICU stay days and number of deaths were compared between the two groups before and after treatment.The two groups were compared for differences in invasive mechanical ventilation and CRRT,as well as differences in newly developed organ dysfunction(heart,lung,circulation,liver,and kidney)during treatment.RESULTS After treatment,prealbumin and gastric antrum motility index in the observation group were higher than those in the control group,while amylase,intra-abdominal pressure and Marshall score were lower than those in the control group(P<0.05).CRP and MCTSI scores in the observation group were not significantly lower than those in the control group(P>0.05).The relief time of nausea,vomiting and abdominal distension in the observation group was shorter than that in the control group(P<0.05),while the relief time of abdominal pain was not statistically significant between the two groups(P>0.05).The time for the observation group to reach the normal bowel sound,the time for enteral nutrition to reach the standard(D)and the time for MI>0.8 were shorter than those in the control group(P<0.05).There was no statistical difference in the number of cases requiring upgraded invasive mechanical ventilation and CRRT treatment between the two groups(P>0.05).The new renal dysfunction in the observation group wa

关 键 词：新斯的明 重型急性胰腺炎 胃肠道功能 胃窦运动指数 

分 类 号：R969.4[医药卫生—药理学]