体表胃肠起搏治疗早期重症急性胰腺炎并发麻痹性肠梗阻临床研究

目的：观察体表胃肠起搏对早期重症急性胰腺炎（SAP）并发麻痹性肠梗阻的治疗效果。方法将56例急性重症胰腺炎同时伴有麻痹性肠梗阻患者随机分为试验组30例及对照组26例，对照组采取胃肠减压、抑制胰酶分泌等常规治疗措施，在常规治疗基础上试验组加用体表胃肠起搏，对比2组患者腹胀腹痛缓解时间、胃肠道功能恢复时间并监测血淀粉酶（AMY）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）的变化。结果试验组治疗后腹胀腹痛缓解时间、胃肠道功能恢复（肠梗阻解除）时间均短于对照组，差异具有统计学意义（P<0.01）；2组患者血淀粉酶、TNF-α、CRP均随时间呈下降趋势，治疗第5天、10天后治疗组血淀粉酶、TNF-α、CRP下降程度与对照组比较有显著差异（P<0.01）。结论对重症急性胰腺炎并发麻痹性肠梗阻患者进行体表胃肠起搏治疗可获得理想的疗效，能够促进胃肠道功能早期恢复，缓解腹胀、腹痛症状，疗效好、安全性高，仪器携带、操作简便，值得临床推广应用。

An evaluation of surface gastrointestinal pacing for early severe acute pancreatitis with paralytic intestinal obstruction

ObjectiveTo observe and analyze the clinical effect of surface gastrointestinal pacing for early severe acute pancreatitis(SAP)with paralytic intestinal obstruction and to explore a new approach for SAP with gastrointestinal motility disorders.MethodsFifty-six patients of SAP with paralytic intestinal obstruction were randomly divided into experiment group(30 patients)and control group(26 patients).All patients in the both groups received the same conventional therapy of gastrointestinal decompression、inhibition of pancreatic secretion et al. On the basis of treatment above,experiment group was given surface gastrointestinal pacing. The relief time of abdominal pain and distention and the recovery time of gastrointestinal function of two grouphs were compared,at the same time monitoring change of serum amylase(AMY),C reactive protein(CRP),tumor necrosis factor-α(TNF-α).ResultsThe relief time of abdominal pain and distention and the recovery time of gastrointestinal function(the relief intestinal obstruction)in the experiment group were all shorter than those in the control group,there was significantly difference(P<0.01). The concentrations of AMY、TNF-αand CRP all decreased along with time in both group,and those in the experiment group decreased significantly faster than in the control group after 5 and 10 days of treatment(P<0.01).ConclusionSurface gastrointestinal pacing for early SAP with paralytic intestinal obstruction can achieve a more ideal therapeutic effect,it can promote gastrointestinal function the early rehabilitation,release symptom of abdominal pain and abdominal distension,it is effective and safe,the stereopicture is easy to carry and operate,it is worth of clinical popularization and application.