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目的观察芒硝腹部热敷在重症急性胰腺炎患者中的应用效果。方法选择2014年3月—2016年7月收治的重症急性胰腺炎患者69例,随机分为观察组35例与对照组34例。两组均保守治疗加常规护理,包括禁食、胃肠减压、补充血容量、纠正水与电解质平衡;给予生长抑素、抗生素、营养支持治疗,中药灌肠。观察组加芒硝腹部热敷,每次热敷6 h,每日2次。疗程5~7 d。记录两组腹痛缓解时间、首次排便时间、进食时间;记录两组血淀粉酶恢复时间、白细胞恢复时间、血糖恢复时间、血钙恢复时间、C反应蛋白恢复时间;记录两组消化道出血情况、并发症发生情况、手术治疗情况。腹痛缓解时间、首次排便时间、进食时间及各实验室指标恢复时间比较采用t检验,消化道出血发生率、并发症发生率、手术治疗率比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组腹痛缓解时间、首次排便时间、进食时间[(3.47±0.56)、(4.15±0.94)、(4.37±0.62)d]较对照组[(6.38±0.61)、(5.14±1.62)、(6.83±1.14)d]缩短,比较差异有统计学意义(均P<0.05)。观察组血淀粉酶恢复时间、白细胞恢复时间、血糖恢复时间、血钙恢复时间、C反应蛋白恢复时间[(4.23±2.09)、(8.01±3.57)、(8.74±2.06)、(5.42±1.83)、(7.06±2.13)d]较对照组缩短[(7.34±2.94)、(11.95±3.37)、(11.40±3.30)、(9.67±3.35)、(9.38±3.32)d],比较差异有统计学意义(均P<0.05)。观察组消化道出血发生率、并发症发生率、手术治疗率(8.57%、40.00%、11.43%)较对照组(61.76%、76.47%、50.00%)低,比较差异有统计学意义(均P<0.05)。结论芒硝腹部热敷可有效缓解重症急性胰腺炎患者的症状、体征,降低并发症发生率。
Objective To observe the application effect of Glauber’s salt abdomen hot compress in patients with severe acute pancreatitis. Methods Sixty-nine patients with severe acute pancreatitis admitted from March 2014 to July 2016 were randomly divided into observation group (35 cases) and control group (34 cases). Both groups were conservative treatment plus routine nursing, including fasting, gastrointestinal decompression, blood volume replacement, correct water and electrolyte balance; give somatostatin, antibiotics, nutritional support and treatment, enema. Observation group plus Glauber’s belly heat, each heat 6 h, 2 times a day. Course of treatment 5 ~ 7 d. The pain relief time, defecation time and feeding time of the two groups were recorded. The amylase recovery time, leukocyte recovery time, blood glucose recovery time, serum calcium recovery time and C-reactive protein recovery time were recorded. The digestive tract bleeding, Complications, surgical treatment. Abdominal pain relief time, the first defecation time, eating time and the recovery time of each laboratory index t test, the incidence of gastrointestinal bleeding, complication rate, surgical treatment rate compared with the χ ~ 2 test, P <0.05 was statistically significant Significance of learning. Results Compared with the control group [(6.38 ± 0.61), (5.14 ± 1.62), (5.14 ± 1.62), (4.47 ± 0.62) and (4.37 ± 0.62) d, 6.83 ± 1.14) d] shortened, the difference was statistically significant (P <0.05). The serum amylase recovery time, white blood cell recovery time, blood glucose recovery time, blood calcium recovery time and C-reactive protein recovery time in the observation group [(4.23 ± 2.09), (8.01 ± 3.57), (8.74 ± 2.06), (5.42 ± 1.83) , (7.06 ± 2.13) d] were shorter than those in the control group [(7.34 ± 2.94), (11.95 ± 3.37), (11.40 ± 3.30), (9.67 ± 3.35), (9.38 ± 3.32) d, respectively Significance (all P <0.05). The incidence of gastrointestinal bleeding in complication group was lower than that of the control group (61.76%, 76.47%, 50.00%) in the observation group (8.57%, 40.00%, 11.43%), and the difference was statistically significant (P <0.05). Conclusion Glaucoma abdominal heat compression can effectively relieve the symptoms and signs of patients with severe acute pancreatitis and reduce the incidence of complications.