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目的:探讨早期使用硫酸镁治疗急性结石性胆囊炎(ACC)患者对临床症状、血浆血管活性肠肽(VIP)、胃动素(MTL)水平的影响。方法:选取2014-01-2016-03在我院治疗的120例ACC患者,采用前瞻性随机研究方法分为硫酸镁组和常规组,每组各60例。2组患者入院后均采用标准的非手术治疗方法,硫酸镁组入院后即给予50ml硫酸镁进行治疗,后每8h给药1次,对比2组临床症状缓解情况、实施急诊手术治疗率等指标。结果:治疗48h内,硫酸镁组的上腹部疼痛、发热、恶心呕吐、压痛及Murphy征阳性缓解率分别为78.33%、70.59%、91.89%和78.33%,常规组分别为61.67%、68.09%、85.29%和61.67%,硫酸镁组的上腹部疼痛、压痛及Murphy征阳性缓解率均显著高于常规组(P<0.05);治疗48h后,硫酸镁组患者的WBC、N%、CRP、TBIL和VIP水平低于常规组(P<0.05),MTL水平高于常规组(P<0.05);硫酸镁组非手术方案治愈率与常规组比较差异无统计学意义(11.67%vs.6.67%,P>0.05);硫酸镁组的急诊手术率低于常规组的(13.33%vs.30.00%,P<0.05);硫酸镁组择期手术率与常规组比较差异无统计学意义(75.00%vs.63.33%,P>0.05)。结论:早期使用硫酸镁治疗ACC患者能显著缓解患者的临床症状及体征,改善炎症反应水平,降低急诊手术率。
Objective: To investigate the effect of magnesium sulfate on clinical symptoms, plasma vasoactive intestinal peptide (VIP) and motilin (MTL) levels in patients with acute calculous cholecystitis (ACC). Methods: A total of 120 patients with ACC treated in our hospital from January 2014 to June 2016 were selected and prospectively randomized into two groups: 60 cases in each group. Two groups of patients were admitted to the hospital after the standard non-surgical treatment, magnesium sulfate group were given to hospital after treatment with 50ml magnesium sulfate, and then administered once every 8h, the clinical symptoms of two groups compared to relief, the implementation of emergency surgery rate and other indicators . Results: The rate of upper abdominal pain, fever, nausea and vomiting, tenderness and Murphy sign of the magnesium sulfate group were 78.33%, 70.59%, 91.89% and 78.33% respectively within 48 hours after treatment, and 61.67% and 68.09% respectively in the conventional group, 85.29% and 61.67% respectively. The rates of pain, tenderness and positive Murphy sign in the magnesium sulfate group were significantly higher than those in the conventional group (P <0.05). After 48 hours of treatment, the WBC, N%, CRP and TBIL (P <0.05). The level of MTL was higher in the magnesium sulfate group than in the conventional group (P <0.05). There was no significant difference in the cure rate of the non-surgical solution between the magnesium sulfate group and the conventional group (11.67% vs.6.67%, P < P> 0.05). The rate of emergency operation in magnesium sulfate group was lower than that in routine group (13.33% vs. 30.00%, P <0.05). There was no significant difference in the rate of elective surgery between magnesium sulfate group and conventional group (75.00% vs. 63.33%, P> 0.05). Conclusion: The early use of magnesium sulfate in patients with ACC can significantly alleviate the clinical symptoms and signs of patients, improve the level of inflammatory response and reduce the emergency operation rate.