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目的:比较生大黄经鼻肠管与胃管注入治疗重症急性胰腺炎(SAP)的疗效。方法:将76例SAP患者随机分为A、B两组,分别经胃管和鼻空肠管注入生大黄,观察入院0 d、7 d时IL-18、IL-15、PCT,CRP、AMY恢复正常的时间,腹痛腹胀缓解时间,肠道功能恢复时间,并发症发生率及死亡率。结果 :入院0 d时A、B组IL-18均显著高于正常对照组(P<0.01),IL-15均显著低于正常对照组(P<0.01),但IL-18、IL-15在两组之间差异无统计学意义(P>0.05);治疗7 d时A、B组IL-18均比入院时下降,其中以B组下降最明显(P<0.O1)。治疗7 d时A组IL-15与入院时比较差异无统计学意义(P>0.05),但B组IL-15明显升高(P<0.01)。治疗7 d时两组PCT水平均不同程度下降,B组下降更明显(P<0.05)。B组患者CRP、AMY恢复正常时间、肠道功能恢复时间、腹痛腹胀缓解时间均较A组明显缩短(P<0.05),B组并发症发生率明显低于A组(P<0.05),两组患者死亡率差异无统计学意义(P>0.05)。结论:SAP治疗中,鼻空肠管注入生大黄优于经胃管给药。
Objective: To compare the efficacy of rhubarb nasal and gastric tube in the treatment of severe acute pancreatitis (SAP). Methods: 76 patients with SAP were randomly divided into A and B groups. The rhubarb was injected via the gastric tube and nasal jejunum. The levels of IL-18, IL-15, PCT, CRP and AMY were observed at 0 and 7 days after admission Normal time, abdominal pain and abdominal distension time, intestinal function recovery time, the incidence of complications and mortality. Results: On the 0th day after admission, the levels of IL-18 in A and B groups were significantly higher than those in normal control group (P <0.01), but IL-15 was significantly lower than that in normal control group (P <0.01) There was no significant difference between the two groups (P> 0.05). On the 7th day after treatment, IL-18 in A and B groups was lower than that at admission, and the decrease was most obvious in group B (P <0.01). IL-15 in group A was not significantly different from that on admission at 7 d (P> 0.05), but IL-15 in group B was significantly increased (P <0.01). The levels of PCT in both groups decreased to different degrees on the 7th day after treatment, and decreased more significantly in the B group (P <0.05). The recovery time of CRP, AMY, recovery time of intestinal function and abdominal distension in group B were significantly shorter than those in group A (P <0.05). The incidence of complications in group B was significantly lower than that in group A (P <0.05) There was no significant difference in mortality rate between the two groups (P> 0.05). Conclusion: In the SAP treatment, nasal jejunum is better than rhubarb administered via gastric tube.