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目的评价施他宁结合芒硝治疗重症急性胰腺炎(SAP)的疗效。方法82例SAP患者随机分成治疗组和对照组,对照组40例,在常规综合对症治疗(包括禁食、胃肠减压、补充血容量、血浆、全静脉营养、抗生素及制酸解痉止痛剂应用等)的基础上,给予施他宁,首剂250μg加入生理盐水在3~5min内缓慢静脉推注,以后6mg/d,24h静脉维持,治疗组42例,在对照组的基础上辅以中药芒硝200g装于白布袋中平敷于中上腹,2次/d;观察两组治疗期间第1、3、5天APACHEⅡ评分、血清淀粉酶、血尿素氮、血钙、血糖、白细胞计数的变化、腹痛、腹胀等主要临床症状改善情况及禁食和住院天数、并发症发生率、手术率和死亡率。结果与对照组相比,施他宁和芒硝联用治疗重症急性胰腺炎,能迅速改善患者病情,患者治疗后的第3天和第5天APACHEⅡ评分明显下降(P<0.05),同时发现其并发症明显降低(P<0.01),手术率及死亡率明显减少(P<0.01),缩短了禁食时间(P<0.01)、腹痛(P<0.01)、腹胀(P<0.01)及住院天数(P<0.01)。结论采用中西医结合的方式,使用施他宁和芒硝联合治疗SAP具有良好的效果,值得临床推广运用。
Objective To evaluate the efficacy of shitainin combined with Glauber’s salt in the treatment of severe acute pancreatitis (SAP). Methods Eighty-two patients with SAP were randomly divided into treatment group and control group, 40 cases in control group were treated with conventional symptomatic treatment (including fasting, gastrointestinal decompression, blood volume, plasma, total parenteral nutrition, antibiotics and antacid antacids Agent application, etc.), given the first dose of 250μg added saline in 3 ~ 5min slow intravenous injection, after 6mg / d, 24h venous maintenance, the treatment group 42 cases on the basis of the control group The Chinese medicine Glauber’s salt 200g was placed in a white cloth bag in the upper abdominal, 2 times / d; APACHE II score, serum amylase, blood urea nitrogen, blood calcium, blood sugar, white blood cell count Changes in abdominal pain, abdominal distension and other major clinical symptoms and improvement of fasting and hospitalization days, the incidence of complications, surgery and mortality. Results Compared with the control group, the combination of shitainine and mirabilite in the treatment of severe acute pancreatitis, can quickly improve the patient’s condition, APACHE Ⅱ score was significantly decreased (P <0.05) on the 3rd and 5th day after treatment, and found that (P <0.01), abdominal pain (P <0.01), abdominal distention (P <0.01) and length of hospital stay (P <0.01) (P <0.01). Conclusion The combination of Chinese and Western medicine, the use of combination of shitaining and mirabilite SAP has a good effect, worthy of clinical promotion and use.