本文選題：大腸水療　切入點：急性胰腺炎　出處：《延安大學》2014年碩士論文

【摘要】：目的觀察早期大腸水療輔助治療急性胰腺炎的療效及安全性。 方法根據(jù)嚴格的納入和排除標準，選取我院急性胰腺炎患者70例，隨機分為常規(guī)治療組(對照組)和水療組。對照組給予禁食、胃腸減壓、解痙鎮(zhèn)痛、糾正水電解質(zhì)平衡、抑酸、抗炎、抑制胰液分泌，水療組除了給予常規(guī)治療外，并于入院第2、4、6天應用腸道水療機進行腸道水療，每日1次。所有試驗對象于入院第1、7天檢測血淀粉酶(S-Amy)、尿淀粉酶(U-Amy)、白細胞(WBC)、C反應蛋白(CRP)，評估腹脹、腹痛、腸鳴音積分、APACHE—II評分、CTSI評分并比較兩組有無顯著性差異；比較兩組腹脹、腹痛、腹部壓痛緩解時間，開放飲食時間，平均住院時間、感染及胸腹水發(fā)生率、治療費用有無顯著性差異；觀察水療組患者在行大腸水療過程中的不良反應。 結(jié)果本研究共納入70例受試者，其中對照組為35例，水療組為35例。水療組經(jīng)治療后血淀粉酶、C-反應蛋白、腹脹積分、腸鳴音積分較對照組下降趨勢顯著增快，腹脹緩解時間、開放飲食時間與對照組相比明顯縮短，感染及胸腹水發(fā)生率較對照降低，差異有統(tǒng)計學意義（P0.05）。治療后水療組WBC計數(shù)、平均住院時間、治療費用、APACHEⅡ評分、CTSI評分與對照組相比差異無統(tǒng)計學意義（P0.05）。輕癥胰腺炎患者經(jīng)治療后水療組在腹痛積分，腹痛、腹部壓痛緩解時間較對照組縮短，差異有統(tǒng)計學意義（P0.05），重癥胰腺炎患者經(jīng)治療后腹痛積分，腹痛、腹部壓痛緩解時間與對照組無明顯差異。水療組患者在行大腸水療過程中僅少數(shù)感一過性腹脹痛不適，未發(fā)現(xiàn)嚴重不良反應。 結(jié)論 1．對于MAP患者早期大腸水療可以迅速改善腹脹、腹痛、腹部壓痛癥狀，促進腸鳴音恢復，降低S-Amy、U-Amy、CRP水平，表明大腸水療可以作為MAP患者輔助治療措施。 2．對于SAP患者早期大腸水療可以迅速改善腹脹癥狀，促進腸鳴音恢復，降低S-Amy、CRP水平，，提示大腸水療可作為SAP特別伴有腸功能不全患者的輔助治療措施。但對于腹痛、腹部壓痛緩解時間與對照組相似。 3．大腸水療組在治療期間未發(fā)現(xiàn)嚴重不良反應，提示有較好的安全性。 4．大腸水療可減少AP感染及胸腹水發(fā)生率。
[Abstract]:Objective to observe the efficacy and safety of early colorectal hydrotherapy in the treatment of acute pancreatitis.Methods according to strict inclusion and exclusion criteria, 70 patients with acute pancreatitis in our hospital were randomly divided into routine treatment group (control group) and hydrotherapy group.The control group was given fasting, gastrointestinal decompression, spasmolysis and analgesia, correcting the balance of water and electrolyte, inhibiting acid, anti-inflammation and inhibiting pancreatic juice secretion. In addition to routine treatment, the hydrotherapy group was treated with intestinal hydrotherapy on the 4th day of admission.Once a day.All subjects were tested for serum amylase S-Amyn, urine amylase U-Amyn, WBC C-reactive protein (WBC) C-reactive protein (CRP) on the 7th day after admission to the hospital to assess abdominal distension, abdominal pain, bowel sound score, APACHE-II score, CTSI score and no significant difference between the two groups, abdominal distension and abdominal pain were compared between the two groups, and there was no significant difference between the two groups in the assessment of abdominal distension, pain and pain.The time of relieving abdominal tenderness, the time of open diet, the average time of hospitalization, the incidence of infection and hydrothorax, and the cost of treatment were significantly different.Results there were 70 subjects in this study, including 35 cases in control group and 35 cases in hydrotherapy group.After treatment, the serum amylase C-reactive protein, abdominal distention score and bowel sound score in the hydrotherapy group increased significantly than those in the control group, the abdominal distension relief time and the open diet time were significantly shorter than those in the control group.The incidence of infection and hydrothorax was significantly lower than that of control group (P 0.05).After treatment, there was no significant difference in WBC count, average hospitalization time, cost of treatment and Apache 鈪

本文編號：1697862