早期应用生大黄治疗重症急性胰腺炎的疗效观察

目的探讨早期经鼻饲及保留灌肠应用生大黄对重症急性胰腺炎（SAP）的疗效。方法将60例SAP患者随机分为两组，大黄治疗组28例和常规治疗组32例，常规治疗组按SAP常规予禁食、胃肠减压、液体复苏、抑酸、应用生长抑素、抗感染及纠正水、电解质、酸碱失衡等治疗；大黄治疗组在常规治疗的基础上早期给予生大黄液经胃管注入及保留灌肠。观察两组患者的腹痛缓解时间、胃肠道功能恢复时间、全身炎症反应综合征（SIRS）改善时间、血淀粉酶恢复时间、并发症发生率、病死率及平均住院日。结果大黄治疗组患者的腹痛缓解时间为（6．1±2．1）d，胃肠道功能恢复时间为（7．2±1．9）d，SIRS改善时间为（8．1±1．3）d，血淀粉酶恢复时间为（9．6±1．3）d，并发症发生率为25％，病死率为3．6％，平均住院时间日为（18．2±9．1）d，均较常规治疗组显著降低（P〈0．05）。结论早期应用生大黄液经胃管注入及保留灌肠治疗SAP可显著改善病情、缩短病程、减少并发症的发生，改善患者预后。

The Effect of Early Application of Rhubarb Treatment for Severe Acute Pancreatitis

Objective To investigate the therapeutic effect in the early stage by using rhubard by nasal feeding and retention enema for severe acute pancreatitis （SAP）. Methods 60 patients of SAP were randomly divided into two kinds of treatment groups ,that was ,rhubard treatment group（ n = 28 ） and conventional treatment group（ n = 32 ）. Conventional treatment group re- ceived routine treatment including fasting, gastrointestinal decompression, fluid resuscitation, acid suppression, use of somatosta- tin, anti-infection and correcting water, electrolyte, acid-base balance treatment ; while rhubard treatment group was on the basis of conventional therapy early given rude rbubard by nasogastric feeding and retention enema. Clinical and laboratory parameters in- cluding relief time of abdominal pain, GI function recovery and SIRS improvement, amylase becoming normal, total complications rate, mortality rate and mean hospitalized days were recorded and compared between the two groups. Results The time of easing abdominal pain with rhubarb treatment group was（6.1 ±2.1 ）d,the time of GI function recovery was（7.2 ±1.9） d,the time of improving SIRS was （ 8. 1 ± 1.3 ） d, the recovery time of serum amylase was （ 9.6 ±1.3 ） d, total complications rate was 25 % , mortality rate was 3.6 % , average days of hospitalization were （ 18.2 ±9.1 ） d , those in conventional therapy group were signiflcantly lower（ P 〈 0.05 ）. Conclusion Early rbubard therapy by nasogastric feeding and retention enema was effective in improving the conditions of SAP, shortening course of disease, reducing the occurrence of complication and improving the prognosis.