早期大肠水疗辅助治疗急性胰腺炎的临床观察

发布时间：2018-04-02 00:01

  本文选题：大肠水疗　切入点：急性胰腺炎　出处：《延安大学》2014年硕士论文

【摘要】：目的观察早期大肠水疗辅助治疗急性胰腺炎的疗效及安全性。 方法根据严格的纳入和排除标准，选取我院急性胰腺炎患者70例，随机分为常规治疗组(对照组)和水疗组。对照组给予禁食、胃肠减压、解痉镇痛、纠正水电解质平衡、抑酸、抗炎、抑制胰液分泌，水疗组除了给予常规治疗外，并于入院第2、4、6天应用肠道水疗机进行肠道水疗，每日1次。所有试验对象于入院第1、7天检测血淀粉酶(S-Amy)、尿淀粉酶(U-Amy)、白细胞(WBC)、C反应蛋白(CRP)，评估腹胀、腹痛、肠鸣音积分、APACHE—II评分、CTSI评分并比较两组有无显著性差异；比较两组腹胀、腹痛、腹部压痛缓解时间，开放饮食时间，平均住院时间、感染及胸腹水发生率、治疗费用有无显著性差异；观察水疗组患者在行大肠水疗过程中的不良反应。 结果本研究共纳入70例受试者，其中对照组为35例，水疗组为35例。水疗组经治疗后血淀粉酶、C-反应蛋白、腹胀积分、肠鸣音积分较对照组下降趋势显著增快，腹胀缓解时间、开放饮食时间与对照组相比明显缩短，感染及胸腹水发生率较对照降低，差异有统计学意义（P0.05）。治疗后水疗组WBC计数、平均住院时间、治疗费用、APACHEⅡ评分、CTSI评分与对照组相比差异无统计学意义（P0.05）。轻症胰腺炎患者经治疗后水疗组在腹痛积分，腹痛、腹部压痛缓解时间较对照组缩短，差异有统计学意义（P0.05），重症胰腺炎患者经治疗后腹痛积分，腹痛、腹部压痛缓解时间与对照组无明显差异。水疗组患者在行大肠水疗过程中仅少数感一过性腹胀痛不适，未发现严重不良反应。 结论 1．对于MAP患者早期大肠水疗可以迅速改善腹胀、腹痛、腹部压痛症状，促进肠鸣音恢复，降低S-Amy、U-Amy、CRP水平，表明大肠水疗可以作为MAP患者辅助治疗措施。 2．对于SAP患者早期大肠水疗可以迅速改善腹胀症状，促进肠鸣音恢复，降低S-Amy、CRP水平，，提示大肠水疗可作为SAP特别伴有肠功能不全患者的辅助治疗措施。但对于腹痛、腹部压痛缓解时间与对照组相似。 3．大肠水疗组在治疗期间未发现严重不良反应，提示有较好的安全性。 4．大肠水疗可减少AP感染及胸腹水发生率。
[Abstract]:Objective to observe the efficacy and safety of early colorectal hydrotherapy in the treatment of acute pancreatitis.Methods according to strict inclusion and exclusion criteria, 70 patients with acute pancreatitis in our hospital were randomly divided into routine treatment group (control group) and hydrotherapy group.The control group was given fasting, gastrointestinal decompression, spasmolysis and analgesia, correcting the balance of water and electrolyte, inhibiting acid, anti-inflammation and inhibiting pancreatic juice secretion. In addition to routine treatment, the hydrotherapy group was treated with intestinal hydrotherapy on the 4th day of admission.Once a day.All subjects were tested for serum amylase S-Amyn, urine amylase U-Amyn, WBC C-reactive protein (WBC) C-reactive protein (CRP) on the 7th day after admission to the hospital to assess abdominal distension, abdominal pain, bowel sound score, APACHE-II score, CTSI score and no significant difference between the two groups, abdominal distension and abdominal pain were compared between the two groups, and there was no significant difference between the two groups in the assessment of abdominal distension, pain and pain.The time of relieving abdominal tenderness, the time of open diet, the average time of hospitalization, the incidence of infection and hydrothorax, and the cost of treatment were significantly different.Results there were 70 subjects in this study, including 35 cases in control group and 35 cases in hydrotherapy group.After treatment, the serum amylase C-reactive protein, abdominal distention score and bowel sound score in the hydrotherapy group increased significantly than those in the control group, the abdominal distension relief time and the open diet time were significantly shorter than those in the control group.The incidence of infection and hydrothorax was significantly lower than that of control group (P 0.05).After treatment, there was no significant difference in WBC count, average hospitalization time, cost of treatment and Apache 鈪

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