肠道水疗对急性胰腺炎重症转化的防治作用

目的评价肠道水疗对防止急性胰腺炎重症(SAP)转变的作用,分析其作用机制.方法将62例急性胰腺炎(AP)患者随机分为治疗组、对照组;并将32例健康献血者作为正常对照;治疗组除行常规治疗外,同时给予每日1次的肠道水疗,对所有实验对象同时检测血清内毒素(ET)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)和血淀粉酶(AMS);观察腹痛缓解时间及统计住院时间.结果 AP患者ET、CRP和IL-6均显著高于正常对照组(P<0.05);治疗组ET、CRP和IL-6的下降幅度显著比对照组大(P<0.05):治疗组腹痛缓解时间、AMS降至正常时间比对照组快(P<0.05);治疗组有1例转变为重症,占3.57%(1/28),对照组有7例转变为重症,占20.59%(7/34),两者比较差异有统计学意义(P<0.05).结论肠道水疗可防止AP向SAP转变;促进肠蠕动,加速肠腔内毒素排除是其主要机制.

Effects and treatment of whole gut washout on patients of acute pancreatitis

Objective To evaluate the role of whole gut washout in preventing transformation of serious acute pancreatitis(SAP) from acute pancreatitis(AP) in the patients and to discuss its mechanism.Methods Sixty-two AP patients were ramdomed into treatment group and control group.And thirty-two healthy volunteers served as normal control group.Besides the routine treatment,the treatment group simultaneously accepted the whole gut washout once a day.Serum endotoxin(ET),c-reactive protein(CRP), interleukin-6(IL-6) and serum amylase(AMS) were detected meantime in all the subjects.Abdominal pain time and hospitalization time were calculated.Results ET,CRP and IL-6 of AP patients were all significantly higher than those of the normal controls(P< 0.05).ET,CRP and IL-6 in the treatment group decreased faster than those in the control group(P< 0.05).The alleviating time of abdominal pain and reducing to normal time of AMS were quicker in the treatment group than the control group.One case in the treatment group was tranformed into SAP(1/28),while seven cases in the control group were transformed into SAP(7/34),showing statistic difference(P< 0.05).Conclusion Whole gut washout can prevent transformation of AP into SAP.To accelerate intestinal wriggle and eliminate intestinal ET is its major mechanism.