早期应用生大黄对重症急性胰腺炎的疗效

目的探讨早期应用生大黄液对并发肠麻痹的重症急性胰腺炎(SAP)的治疗效果及对其预后的影响。方法将48例并发肠麻痹的SAP患者随机分为对照组和治疗组,对照组按照SAP常规处理原则予监护,禁食,胃肠减压,抑酸,应用生长抑素,抗生素,纠正水、电解质、酸碱平衡等支持治疗;治疗组在此基础上给予生大黄液胃管注入。观察两组患者的腹痛腹胀缓解时间、胃肠道功能恢复时间、全身炎症反应综合征(SIRS)改善时间、并发症发生的例数、病死率、住院时间及住院费用。结果两组患者的腹痛腹胀缓解时间、胃肠道功能恢复时间、SIRS改善时间、住院时间及住院费用有显著性差异(P<0.01);治疗组并发症发生率低于对照组(P<0.05),但两组病死率无显著性差异(P>0.05)。结论生大黄液能缩短SAP的病程,降低住院费用,是治疗SAP肠麻痹的理想药物,可以常规早期使用。

Early use of rhubard in treatment of severe acute pancreatitis.

Objective To evaluate the therapeutic effect of early rhubard treatment on severe acute pancreatitis (SAP) complicated with paralytic intestinal obstruction. Methods Forty-eight SAP cases were randomly divided into rhubard treatment group and control group. Patients in control group received routine treatment including intensive care, fasting, acid inhibitor, somatostatin, antibiotics and supporting therapy.Patients in rhubard group received routine treatment plus early rhubard infusion from a gastric tube. Clinical and laboratory parameters including relief time of abdominal pain and bloating, GI function recovery and SIRS improvement, total complications, mortality, mean hospitalized days and medical costs were recorded and compared between the two groups. Results The relief time of abdominal pain and bloating, GI function recovery, SIRS relief, hospitalized days and medical costs in rhubard group were significantly lower than those in control (P < 0.01); there were fewer complications in rhubard group (P < 0.05), and there was no significant difference in the mortality rate between the two groups (P > 0.05). Conclusions Rhubard therapy was effective in decreasing SAP duration and medical cost, especially in those complicated with paralytic intestinal obstruction. So we suggest early routine use of rhubard in SAP.