枯草杆菌屎肠球菌辅助治疗重症急性胰腺炎的临床疗效分析

Clinical effect of bacillus subtilis for assisted treatment of severe acute pancreatitis

  • 摘要: 目的 探讨枯草杆菌屎肠球菌辅助治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的效果。 方法 选取2008年1月-2013年10月于本院住院的重症急性胰腺炎患者138例,随机分为研究组(常规治疗加用枯草杆菌屎肠球菌)和对照组(常规治疗),观察两组症状、胰酶变化、住院天数及并发症情况,分析入院当天和治疗2周时患者的急性生理功能和慢健康状况(acute physiology and chronic health evaluation,APACHEⅡ)评分、CT严重度指数(CT severity index,CTSI)评分和胃肠功能评分,以及治疗有效率、并发症发生率。 结果 研究组淀粉酶和脂肪酶恢复时间分别为(6.2±3.8) d、(6.8±4.9) d,腹痛和腹胀症状消失时间分别为(20.8±6.8) d、(26.7±12.8) d,住院天数为(29.7±15.4) d,均明显短于对照组,对照组上述指标依次为(7.8±4.3) d、(9.2±5.8) d、(24.4±11.8) d、(32.7±14.9) d、(35.8±16.9) d(P< 0.05);研究组患者入院治疗2周时胃肠功能评分(0.6±0.3)、APACHEⅡ评分(4.2±1.9)均明显低于对照组(0.8±0.5、5.4±3.4),两组差异有统计学意义(P< 0.05),但CTSI评分两组差异无统计学意义(P> 0.05);研究组治疗有效率(79.2%)明显高于对照组治疗有效率(63.6%)(P< 0.05);研究组并发症发生率(66.7%)低于对照组(84.8%)(P< 0.05)。 结论 在重症急性胰腺炎治疗过程中加用枯草杆菌屎肠球菌能够促进胃肠功能恢复,有减少并发症、改善预后的效果。

     

    Abstract: Objective To explore the clinical effect of bacillus subtilis for assisted treatment of severe acute pancreatitis (SAP). Methods One hundred and thirty-eight patients with SAP from January 2008 to October 2013 in Navy General Hospital were randomly divided into two groups: study group (common therapy and bacillus subtilis) and control group (common therapy). Symptoms, trypsin, hospital time and complications of patients with SAP were observed. Acute physiology and chronic health evaluation (APACHEⅡ) score, CT severity index (CTSI) score, gastrointestinal function score of patients on the first day and 2 weeks after admission and treatment efficiency were analyzed. Results The time of amylase resume, abdominal pain and distention release and hospitalization of patients in study group were 6.2±3.8 d, 6.8±4.9 d, 20.8±6.8 d, 26.7±12.8 d, and 29.7±15.4 d, respectively, which were significantly shorter than control group (P< 0.05). The gastrointestinal function score and APACHEⅡscore of patients in study group were 0.6±0.3 and 4.2±1.9, respectively, which were significantly lower than control group (0.8±0.5 and 5.4±3.4) on the two-week of admission (P< 0.05), while the CTSI score in two groups had no significant difference (P> 0.05). The treatment efficiency of study group was higher than control group (79.2% vs 63.6%, P< 0.05). Incidence of complications of study group was lower than control group (66.7% vs 84.8%, P< 0.05). Conclusion During the treatment of SAP, bacillus subtilis assistant treatment can shorten hospitalization time, improve the recovery of gastrointestinal function and raise the treatment effect, which plays an important role in reducing complications and improving prognosis.

     

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