摘要
目的探讨三联活菌散在辅助治疗重症急性胰腺炎（severe acute pancreatitis,SAP）中的临床疗效。方法选取2013年1月-2015年12月我院消化内科收治的急性重症胰腺炎患者68例,随机分为实验组（n=34）与对照组（n=34）。在禁食、抑酸、抑制胰液分泌、维持水电解质平衡、营养支持、抗感染等治疗的基础上,实验组患者加用双歧杆菌、乳酸杆菌、粪链球菌三联活菌散.比较两组治疗后的炎性指标及并发症发生率差异。结果两组性别、年龄、入院APACHE-Ⅱ评分、Ranson评分、合并症等差异无统计学意义（P〉0.05）;两组入院治疗后14 d,实验组C-反应蛋白（C-reaction protein,CRP）为（53.1±16.9）mg/L,白细胞计数（white blood cell count,WBC）为（7.1±1.6）×10^9/L,血清淀粉酶（amylase,AMY）为（265.8±46.2）U/L,内毒素（endotoxin,ET）为（0.12±0.03）EU/ml,乳酸脱氢酶（lactate dehydrogenase,LDH）为（45.8±11.2）U/L,对照组CRP为（62.9±19.7）mg/L,WBC为（8.2±1.9）×10^9/L,AMY为（291.6±51.8）U/L,ET为（0.15±0.04）EU/ml,LDH为（52.1±13.7）U/L,实验组相关炎性指标值均显著低于对照组（P〈0.05）;实验组胃肠道功能恢复时间为（8.2±2.7）d,胰周感染发生率为14.7%,住院时间为（19.5±3.4）d,而对照组胃肠道功能恢复时间为（9.8±3.1）d,胰周感染发生率为38.2%,住院时间为（21.1±2.9）d,实验组各项指标均低于对照组（P〈0.05）;实验组死亡率为5.9%,低于对照组的11.8%,但差异无统计学意义。结论在综合治疗基础上加用双歧杆菌、乳酸杆菌、粪链球菌三联活菌散,对于减轻SAP患者体内炎症反应、降低感染发生率以及促进胃肠功能的恢复具有重要作用。
Objective To discuss the efficacy of intestinal micro-ecological preparations（trigeminy viable organism powder） in adjunctive therapy to patients with severe acute pancreatitis. Methods Sixty-eight patients with severe acute pancreatitis who were treated in our hospital from January 2013 to December 2015 were selected, and they were randomly divided into experimental group（n=34） and control group（n=34）. In addition to the basic treatment of fasting, inhibition of gastric and pancreatic secretion, restoring water and electrolytes balance, nutritional support, anti-infection and so on, patients in experimental group were further treated with micro ecological preparation- Bifico. Then the inflammatory indicators, incidence of complications of patients in each group after treatment were compared. Results There were no significant differences in patients＇ gender, age, APACHE- Ⅱ score at admission, Ranson score, organ dysfunction, etc（P 0.05）. After treatment for 14 days, the inflammatory indicators in experimental group were significantly lower than control group [CRP：（53.1±16.9） mg/L vs（62.9±19.7） mg/L, WBC：（7.1±1.6）×10^9/L vs（8.2±1.9）×10^9/L,AMY：（265.8±46.2） U/L vs（291.6±51.8） U/L, ET：（0.12±0.03） EU/ml vs（0.15±0.04） EU/ml, LDH：（45.8±11.2） U/L vs（52.1±13.7） U/L, P 0.05], and the patients＇ recovery time of gastrointestinal function, incidence of pancreatic infection, hospitalization time in experimental group were also significantly lower than control group [（8.2±2.7） d vs（9.8±3.1） d, 14.7% vs 38.2%,（19.5±3.4） d vs（21.1±2.9） d, P 0.05]. Meanwhile, there was no significant difference in mortality between two groups（5.9% vs 11.8%）. Conclusion Based on the comprehensive treatment, intestinal micro-ecological preparations is important in the adjuvant treatment in alleviating the inflammatory response, reducing the infection rate and promoting the recovery of gastrointestinal function in patients with SAP.
作者
柴小兵
罗金键
CHAI Xiaobing LUO Jinjian(Department of Gastroenterology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, Hen Province, Chin)
出处
《解放军医学院学报》
CAS
2016年第9期967-969,987,共4页
Academic Journal of Chinese PLA Medical School
关键词
重症急性胰腺炎
治疗
肠道微生态制剂
severe acute pancreatitis
therapy
intestinal micro-ecological preparation
