摘要
目的 观察早期应用中药 (芒硝、生大黄 )保留灌肠选择性肠道去污染 (selective decon-tam ination of the digestive tract,SDD)对重症胰腺炎 (severe acute pancreatitis,SAP)的治疗作用。方法 2 0 0 0年 3月至 2 0 0 2年 9月收治 SAP4 3例 ,患者入院后随机分为治疗组和对照组。治疗前治疗组与对照组患者 APACHE- 积分、Ranson积分和 CT分级比较无统计学差异。治疗组 2 3例 ,入院后 2 4 h给芒硝、生大黄保留灌肠 ,余同对照组治疗 ;对照组 2 0例 ,予禁食、胃肠减压、抑酸、抑酶、抗感染及对症、支持治疗等 ;观察两组早期 (1周 )胰腺感染率、早期 (1周 )多脏器功能衰竭 (Multiple- organ dysfunctionsyndrome,MODS)发生率、霉菌感染率、后期 (4周 )脓肿形成率、治愈率、死亡率、住院时间、住院费用。结果 治疗组和对照组早期胰腺感染率分别为 4 .34%和 2 0 % (P<0 .0 5 ) ,早期 MODS发生率分别为4 .34%和 2 0 % (P<0 .0 5 ) ,后期脓肿形成率分别为 4 .34%和 10 % (P<0 .0 5 ) ,霉菌感染率分别为 8.7%和 35 % (P<0 .0 5 ) ,治愈率分别为 95 .6 6 %和 85 % (P<0 .0 5 ) ,死亡率分别为 4 .34%和 15 % ,(P<0 .0 5 ) ,住院时间分别为 (2 0 .3± 19.6 ) d和 (32 .1± 18.4 ) d,住院费用分别为 2 92
Objective To evaluate the therapeutic effect of selective decontamination of the digestive tract using traditional Chinese drugs (Glauber's salt and Crude rhubarb) on severe acute pancreatitis (SAP). Methods 43 SAP patients admitted from March 2000 to September 2002 were randomized into a treatment group(n=23) and a control group(n=20). There were no statistically significant differences in APACHE-Ⅱ score, Ranson score and CT classification between the two groups before treatment. The control group received starvation, gastric decompression, antacid, amylase inhibition, anti-infection, symptomatic and supportive therapies. The treatment group received the same treatment as the control group did except that the former were given Glauber's salt and Crude rhubarb for retention-enema 24 h after admission. The incidences of early (one week) pancreatic infection, early (one week) multi-organ dysfunction syndrome and mycotic infection, the incidence of late (4 weeks) abscess formation, curative rate, mortality, hospital stay and medical cost were observed and compared between the two groups. Results The incidence of early pancreatic infection was 13.1% vs 40% between the treatment group and the control group; the incidence of late abscess formation was 4.34% vs 10%; the infection rate was 13.1% vs 35%; the incidence of MODS was 21.7% vs 50%; the early mortality rate was 8.7% vs 20%; hospital stay was 20.3 ± 19.6 days vs 32.1 ± 18.4 days, and the mean medical cost was 29 217 RMB vs 47 509 RMB. Conclusions The therapeutic outcomes of the treatment group were better than those of the control group with regard to early pancreatic infection, early MODS occurrence, mortality rate, hospital stay and medical cost. There was no statistical discrepancy in late abscess formation between the two groups.
出处
《胰腺病学》
2003年第3期162-164,共3页
Chinese JOurnal of Pancreatology
关键词
中药
选择性肠道去污染
重症胰腺炎
治疗
Entero microbiology
Pancreatitis
Rheum palmatum
Matrii sulfas
Therapeutic use
