急性胰腺炎消化内科治疗的临床疗效探讨
|
摘要
目的分析急性胰腺炎消化内科治疗的临床疗效影响因素。方法选择2015年1月-2018年8月茌平县人民医院收治的142例急性胰腺炎患者,按照临床疗效进行分组,其中疾病进展(轻度转为重症化、转手术治疗)、严重并发症、住院时间超过3/4四分位位数的对象纳入不良组,其余对象纳入对照组。收集患者的临床资料,进行因素分析。结果不良组年龄、病程、尿淀粉酶、APACHEⅡ评分高于对照组,差异有统计学意义(P<0.05)。不良组与对照组的胆源性CT3-4级、糖尿病、早期营养支持比重差异有统计学意义(P<0.05)。年龄、APACHEⅡ评分、CT 3-4级、糖尿病、早期营养支持为独立影响因素,差异有统计学意义(P<0.05)。结论急性胰腺炎消化内科治疗的临床疗效尚可,但疗效影响因素较多;对于高危对象,需要提高监护、治疗标准,重视代谢管理、糖尿病治疗,发挥早期营养支持的价值。
Objective To analyze the influencing factors of clinical efficacy of digestive medicine for acute pancreatitis. Methods From January 2015 to August 2018,142 patients with acute pancreatitis admitted to Chiping County People's Hospital were enrolled and grouped according to clinical efficacy. The disease progressed(slightly converted to severe disease and surgical treatment),serious complications,and length of stay with more than 3/4 quartiles were included in the adverse group,and the remaining subjects were included in the control group. The clinical data of the patients were collected and factor analysis was performed. Results The age,course of disease,urinary amylase and APACHE II scores of the adverse group were higher than those of the control group,and the difference was statistically significant(P<0.05).There was a statistically significant difference in the proportion of biliary CT 3-4,diabetes and early nutritional support between the adverse group and the control group(P<0.05). The age,APACHE II score,CT 3-4 grade,diabetes,early nutritional support became independent factors,the difference was statistically significant(P<0. 05). Conclusion The clinical efficacy of digestive medicine in acute pancreatitis is acceptable,but there are many factors influencing the curative effect. For high-risk subjects,it is necessary to improve the monitoring and treatment standards and attach importance to metabolic management,diabetes treatment,the value of early nutritional support.
Objective To analyze the influencing factors of clinical efficacy of digestive medicine for acute pancreatitis. Methods From January 2015 to August 2018,142 patients with acute pancreatitis admitted to Chiping County People's Hospital were enrolled and grouped according to clinical efficacy. The disease progressed(slightly converted to severe disease and surgical treatment),serious complications,and length of stay with more than 3/4 quartiles were included in the adverse group,and the remaining subjects were included in the control group. The clinical data of the patients were collected and factor analysis was performed. Results The age,course of disease,urinary amylase and APACHE II scores of the adverse group were higher than those of the control group,and the difference was statistically significant(P<0.05).There was a statistically significant difference in the proportion of biliary CT 3-4,diabetes and early nutritional support between the adverse group and the control group(P<0.05). The age,APACHE II score,CT 3-4 grade,diabetes,early nutritional support became independent factors,the difference was statistically significant(P<0. 05). Conclusion The clinical efficacy of digestive medicine in acute pancreatitis is acceptable,but there are many factors influencing the curative effect. For high-risk subjects,it is necessary to improve the monitoring and treatment standards and attach importance to metabolic management,diabetes treatment,the value of early nutritional support.
引文
[1]林晚,张旭,张飞雄,等.中国人群高脂血症性急性胰腺炎与急性胆源性胰腺炎临床特征的Meta分析[J].宁夏医科大学学报,2017,39(9):1085-1090.
[2]陈宏.CT、MRI对急性胰腺炎的诊断价值比较[J].中国CT和MRI杂志,2017,15(5):103-105.
[3]朱刚,梁桂珍.不同时间肠内营养支持对重症急性胰腺炎患者细胞免疫功能及并发症的影响[J].医学理论与实践,2018,31(17):2587-2588.
[4]张剑,朱林,李文尧,等.益生菌联合谷氨酰胺对急性重症胰腺炎患者肠黏膜屏障功能的影响[J].中国中西医结合消化杂志,2018,26(3):293-296.
[5]张波,颜廷爽,李锋.生长抑素类药物联合前列地尔对高脂血症急性胰腺炎疗效的Meta分析[J].微循环学杂志,2018,28(3):58-63,70.
[6]皮园园,张先杰,姜涛.清胰汤治疗急性胰腺炎随机对照试验的Meta分析[J].世界中医药,2018,13(6):1546-1552.
[2]陈宏.CT、MRI对急性胰腺炎的诊断价值比较[J].中国CT和MRI杂志,2017,15(5):103-105.
[3]朱刚,梁桂珍.不同时间肠内营养支持对重症急性胰腺炎患者细胞免疫功能及并发症的影响[J].医学理论与实践,2018,31(17):2587-2588.
[4]张剑,朱林,李文尧,等.益生菌联合谷氨酰胺对急性重症胰腺炎患者肠黏膜屏障功能的影响[J].中国中西医结合消化杂志,2018,26(3):293-296.
[5]张波,颜廷爽,李锋.生长抑素类药物联合前列地尔对高脂血症急性胰腺炎疗效的Meta分析[J].微循环学杂志,2018,28(3):58-63,70.
[6]皮园园,张先杰,姜涛.清胰汤治疗急性胰腺炎随机对照试验的Meta分析[J].世界中医药,2018,13(6):1546-1552.