【摘要】 目的探讨腹腔双套管持续冲洗联合芒硝外敷治疗重症急性胰腺炎(SAP)的临床效果及护理方法。方法选取2018年10月～2019年10月我院收治的142例SAP患者,采用随机数字表法分为两组,每组各71例。对照组采取常规治疗,试验组采取腹腔双套管持续冲洗联合芒硝外敷治疗,治疗1周为1个疗程,期间配合护理干预。比较两组生命体征、炎症指标水平、症状改善时间,并观察至4周后,评估胰腺渗出吸收情况。结果两组治疗前的生命体征、炎症指标水平比较,差异无统计学意义(P>0.05);试验组治疗1周后的平均动脉压为(87.95±7.76)mmHg,高于对照组的(83.64±7.82)mmHg,呼吸频率、心率、白细胞计数(WBC)、C反应蛋白(CRP)[(19.11±2.29)次/min、(93.88±8.69)次/min、(12.09±2.06)×10~9/L、(37.62±7.78)mg/L],低于对照组[(21.43±2.18)次/min、(100.47±8.83)次/min、(13.57±2.24)×10~9/L、(45.35±8.62)mg/L],差异均有统计学意义(P<0.05);试验组的发热、腹痛及腹胀改善时间[(4.36±1.65)、(4.13±1.29)、(6.38±1.77)d],短于对照组[(5.89±2.03)、(5.72±1.68)、(8.43±2.52)d],差异均有统计学意义(P<0.05);试验组的胰腺渗出吸收率(88.73%)高于对照组(76.06%),差异有统计学意义(P<0.05)。结论腹腔双套管持续冲洗联合芒硝外敷治疗SAP效果显著,有效改善患者体征、症状,降低炎症指标水平,促进胰腺渗出吸收,配合护理干预能降低治疗风险。更多还原

【Abstract】 Objective To explore the clinical effect and nursing method of continuous irrigation of abdominal double cannula combined with external application of mirabilite in the treatment of severe acute pancreatitis(SAP). Methods A total of 142 patients with SAP who were admitted to our hospital from October 2018 to October 2019 were selected.They were divided into two groups by random number table method, 71 cases in each group. The control group was given regular treatment, and the experimental group was given continuous irrigation with abdominal double cannula combined with external application of Mirabilite. The course of treatment was 1 week, accompanied by nursing intervention during the period. The vital signs, inflammation index levels, and symptom improvement time were compared between the two groups until four weeks later, and pancreatic exudative absorption was evaluated. Results The differences in vital signs and levels of inflammation indices before treatment were not statistically significant between the two groups(P>0.05); the average arterial pressure in the experimental group after 1 week of treatment was(87.95 ±7.76) mmHg higher than that in the control group of(83.64 ±7.82) mmHg, respiratory frequency, heart rate, white blood cell count(WBC), creactive protein(CRP)([19.11±2.29] times/min, [93.88±8.69] times/min, [12.09±2.06] ×10~9/L,[37.62±7.78] mg/L) were lower than those in the control group([21.43±2.18] times/min, [100.47±8.83] times/min,[13.57±2.24] ×10~9/L, [45.35±8.62] mg/L), and the differences were statistically significant(P<0.05); the time of improvement in fever, abdominal pain and distention in the experimental group([4.36±1.65], [4.13±1.29], [6.38±1.77] d) were shorter than those in the control group([5.89±2.03] d, [5.72±1.68] d, [8.43±2.52] d), and the differences were statistically significant(P<0.05); the pancreatic exudative absorption rate in the experimental group(88.73%) was higher than that in the control group(76.06%), and the difference was statistically significant(P<0.05). Conclusion The continuous irrigation of abdominal double cannula combined with external application of mirabilite has a significant effect in the treatment of SAP, which effectively improves the patients’vital signs and symptoms, reduces inflammation and index level, and promotes pancreatic exudative absorption. Combined nursing intervention can further reduce the risk of treatment.更多还原