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目的:观察改良结肠滴注法用于重症急性胰腺炎肠麻痹患者的临床疗效。方法:63例重症急性胰腺炎(SAP)合并肠麻痹患者随机分为观察组(32例)与对照组(31例)。两组患者采用不同的灌肠方式治疗15 d。治疗前后采集两组患者外周静脉血,检测血淀粉酶(AMS)、C反应蛋白(CRP)和肿瘤坏死因子(TNF-α)水平变化,观察患者腹痛或腹胀缓解时间、胃肠道功能恢复时间,以及治疗中并发症发生情况。结果:与治疗前比较,两组患者治疗后AMS、CRP、TNF-α呈降低趋势,且观察组低于对照组(P<0.05或P<0.01)。观察组腹痛或腹胀缓解时间以及胃肠道功能恢复时间均短于对照组(P<0.05或P<0.01)。观察组并发症明显低于对照组(P<0.05)。结论:改良结肠滴注法用于重症急性胰腺炎肠麻痹患者,可提高临床疗效,缩短胃肠道功能恢复时间,减少并发症,值得临床推广应用。
Objective: To observe the clinical effect of modified colon instillation in patients with severe acute pancreatitis and intestinal paralysis. Methods: Sixty-three patients with severe acute pancreatitis (SAP) complicated with intestinal paralysis were randomly divided into observation group (32 cases) and control group (31 cases). Two groups of patients with different enemas for 15 days. Peripheral venous blood was collected before and after treatment to detect the changes of serum amylase (AMS), C-reactive protein (CRP) and tumor necrosis factor (TNF-α) levels. The patients’ abdominal pain or abdominal distension time, gastrointestinal function recovery time , And the incidence of complications during treatment. Results: Compared with those before treatment, AMS, CRP and TNF-αwere decreased in both groups after treatment, and the observation group was lower than the control group (P <0.05 or P <0.01). The observation group had shorter duration of abdominal pain or bloating and longer recovery time of gastrointestinal function than those of the control group (P <0.05 or P <0.01). The complication in observation group was significantly lower than that in control group (P <0.05). Conclusion: Modified colon instillation method for severe acute pancreatitis patients with intestinal paralysis can improve clinical efficacy, shorten the recovery time of gastrointestinal function, reduce complications, it is worthy of clinical promotion and application.