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目的:观察血必净注射液辅助治疗重症急性胰腺炎的疗效及对肠道黏膜屏障功能的影响。方法:将84例重症急性胰腺炎患者按随机数字表分为观察组和对照组各42例。对照组接受常规治疗,观察组在对照组用药的基础上接受血必净射液治疗,2组疗程均为10天。比较2组患者的腹痛缓解时间、腹胀缓解时间、肠鸣音恢复时间、首次肛门排便时间,治疗前后检测血清D-乳酸、内毒素、二胺氧化酶、尿乳果糖/甘露醇排出比值,评定胃肠功能评分。同时比较治疗前后血清中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10、C-反应蛋白(CRP)水平、急性生理与慢性健康评分Ⅱ(APACHEⅡ评分)的变化,及相关并发症的发生率和病死率。结果:观察组腹痛缓解、腹胀缓解、肠鸣音恢复、肛门首次排便时间及住院时间均短于对照组(P<0.05)。治疗后,2组血清D-乳酸、内毒素、二胺氧化酶、胃肠道评分及尿乳果糖/甘露醇排出比值均较治疗前降低(P<0.05),观察组血清D-乳酸、内毒素、二胺氧化酶、尿乳果糖/甘露醇排出比值及胃肠道评分均低于对照组(P<0.05)。治疗后,2组TNF-α、IL-6、CRP水平及APACHEⅡ评分均低于治疗前(P<0.05),IL-10水平均高于治疗前(P<0.05);观察组TNF-α、IL-6、CRP水平及APACHEⅡ评分均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。观察组休克、急性呼吸窘迫综合征、急性肾功能衰竭的发生率及病死率均低于对照组(P<0.05)。结论:血必净注射液辅助治疗重症急性胰腺炎能较好地保护肠道黏膜屏障,促进胃肠功能尽早恢复,调节炎症细胞因子继而改善患者的临床指标,减少相关并发症的发生。
Objective: To observe the curative effect of Xuebijing injection in adjuvant treatment of severe acute pancreatitis and its effect on intestinal mucosal barrier function. Methods: Eighty-four patients with severe acute pancreatitis were divided into observation group (n = 42) and control group (n = 42) according to random number table. The control group received routine treatment. The observation group received Xuebijing injection on the basis of the control group. The two courses of treatment were 10 days. Abdominal pain relief time, abdominal distension relief time, bowel sound recovery time, first anal defecation time, serum D-lactate, endotoxin, diamine oxidase, urine lactulose / mannitol excretion rate were compared before and after treatment. Gastrointestinal function score. The changes of serum levels of TNF-α, IL-6, IL-10 and C-reactive protein (CRP), acute physiology and chronic health score Ⅱ (APACHEⅡ) , And related complications and mortality. Results: The observation group was relieved of abdominal pain, relieved abdominal distension, recovery of bowel sounds, shortened anus first defecation time and hospital stay (P <0.05). After treatment, the levels of D-lactate, endotoxin, diamine oxidase, gastrointestinal tract score and urinary lactulose / mannitol excretion in both groups were significantly lower than those before treatment (P <0.05) Toxin, diamine oxidase, urine lactulose / mannitol excretion ratio and gastrointestinal tract scores were lower than the control group (P <0.05). After treatment, the levels of TNF-α, IL-6, CRP and APACHEⅡ in two groups were lower than those before treatment (P <0.05) The level of IL-6, CRP and APACHEⅡwere lower than that of the control group (P <0.05), and the level of IL-10 was higher than that of the control group (P <0.05). Observation group shock, acute respiratory distress syndrome, the incidence of acute renal failure and mortality were lower than the control group (P <0.05). Conclusion: Xuebijing injection adjuvant treatment of severe acute pancreatitis can better protect the intestinal mucosal barrier, promote gastrointestinal function recovery as soon as possible, regulate inflammatory cytokines and then improve the clinical indicators of patients to reduce the incidence of complications.