生大黃及輕質(zhì)液狀石蠟灌胃治療急性胰腺炎的臨床分析

胡華斌 郭焱雄

[摘要]目的 探討生大黃及輕質(zhì)液狀石蠟灌胃治療急性胰腺炎臨床效果。方法 選取我院急診科2014年1月～2016年8月住院的94例急性胰腺炎患者作為研究對(duì)象，隨機(jī)分為對(duì)照組和治療組，每組各46例。對(duì)照組患者采用常規(guī)治療，治療組在常規(guī)治療的基礎(chǔ)上配以100 ml生大黃液及輕質(zhì)液狀石蠟經(jīng)胃管灌注。比較兩組患者肛門排氣時(shí)間、腹痛消失時(shí)間、第一次通便時(shí)間、C反應(yīng)蛋白（CRP）和血淀粉酶降至正常的時(shí)間，觀察兩組患者治療前后APACHE-Ⅱ評(píng)分、Balthazar CT評(píng)分差異。結(jié)果 治療組患者肛門排氣時(shí)間，腹痛消失時(shí)間、第一次通便時(shí)間、CRP及血淀粉酶降至正常的時(shí)間明顯短于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；與對(duì)照組比較，APACHE-Ⅱ評(píng)分差異有統(tǒng)計(jì)學(xué)意義（P<0.05），而Balthazar CT評(píng)分差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 生大黃及輕質(zhì)液狀石蠟灌胃治療急性胰腺炎，改善患者肛門排氣時(shí)間、腹痛消失時(shí)間、第一次通便時(shí)間，明顯縮短CRP及血淀粉酶降至正常的時(shí)間，同時(shí)能明顯降低APACHE-Ⅱ評(píng)分。

[關(guān)鍵詞]急性胰腺炎；生大黃；輕質(zhì)液狀石蠟；灌胃；療效

[中圖分類號(hào)] R576 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2018）4（c）-0045-03

Clinical analysis of rahrhubarb combined with light liquid paraffin in the treatment of acute pancreatitis

HU Hua-bin1 GUO Yan-xiong2▲

Department of Emergency，the First People′s Hospital of Chenzhou City，Hu′nan Province，Chenzhou 423000，China

[Abstract]Objective To observe the clinical effect of rawrhubarb combined with light liquid paraffin in treatment of acute pancreatitis （AP）.Methods A total of 94 patients with AP in emergency department from January 2014 to August 2016 in our hospital were randomly divided into control group and treatment group，46 cases in each group.Control group patients were given standrad treatment，the treatment group was treated with 100 ml raw rhubarb fluid combined with light liquid paraffin by gastric tube on the basis of standard treatment.The anal exhaust time，remission time of abdominal pain，the first laxative time and recovered time of CRP and blood amylase between the two groups were compared，at the same time，the differences of APACHE-Ⅱscore，Balthazar CT score before and after treatment were observed.Results Anal exhaust time，remission time of abdominal pain，the first laxative time were significantly shorter than those in the control group，recovered time of CRP and blood amylase in the treatment group were also significantly shorter than that in the control group.The differences were statistically significant（P<0.05）.Compared with the control group，the APACHE-Ⅱ score had significant difference （P<0.05），but Balthazar CT score had no significant difference （P>0.05）.Conclusion Therapy of raw rhubarb combined with light liquid paraffin in acute pancreatitis patients can significantly reduce the anal exhaust time，remission time of abdominal pain，the first laxative time，recovery time of blood amylase and CRP，the APACHE-Ⅱscore，too.

[Key words]Acute pancreatitis；Rawrhubarb；Light liquid paraffin；Gavage；Efficacy

急性胰腺炎（acute pancreatitis，AP）是臨床常見的急腹癥，是由多種病因引起的胰酶激活，繼以胰腺局部炎性反應(yīng)為主要特征，伴或不伴有其他器官功能改變的急性疾病。臨床上，20%～30%患者臨床經(jīng)過兇險(xiǎn)，總體病死率為5%～10%[1]。發(fā)病早期即可出現(xiàn)惡心、嘔吐、胃潴留、腹脹，肛門停止排便排氣等癥狀。目前，AP治療以禁食、胃腸減壓、液體復(fù)蘇，抑酸抑酶等標(biāo)準(zhǔn)治療為主。大黃是一味中藥，具有清里瀉熱、活血化瘀、消炎抗菌、增強(qiáng)腸道免疫能力功能[2]，輕質(zhì)液狀石蠟具有導(dǎo)瀉作用。……