早期应用柴芩承气汤治疗胆源性重症急性胰腺炎的临床研究_1.docVIP

早期应用柴芩承气汤治疗胆源性重症急性胰腺炎的临床研究 作者：薛平，黄宗文，郭佳，赵健蕾，李永红，王忠朝 【关键词】 ,胆源性重症急性胰腺炎 ［摘要］ 目的：探讨早期 应用 柴芩承气汤 治疗 胆源性重症急性胰腺炎（severe acute pancreatitis, SAP）的疗效。 方法 ：90例符合病例选择标准并接受柴芩承气汤治疗的胆源性SAP住院患者，按院外病程长短分为早期组（3 d内入院接受治疗，54例）和晚期组（3～7 d内入院接受治疗，36例），比较治疗过程中两组患者并发症的发生率、住院时间、手术中转率及病死率。结果：早期组胰性脑病、感染和消化道出血的发生率明显低于晚期组（P＜0.05）。早期组和晚期组住院时间分别为（24.9±18.4）d和（51.6±45.9）d，早期组和晚期组病死率分别为7.4%（4/54例）和25.0%（9/36例），早期组和晚期组中转手术率分别为11.1%（6/54例）和27.8%（10/36例），两组比较差异均有统计学意义（P＜0.05）。结论：早期应用柴芩承气汤治疗胆源性SAP，可减少并发症的发生、缩短住院时间、减少手术中转率及降低病死率。 　　［关键词］ 胆源性重症急性胰腺炎; 柴芩承气汤; 临床 研究 　　Clinical study of Chaiqin Chengqi Decoction in treating severe acute biliary pancreatitis 　　　ABSTRACT Objective: To study the therapeutic effects of Chaiqin Chengqi Decoction (CQCQD) in treating severe acute biliary pancreatitis. Methods: Ninety patients with severe acute biliary pancreatitis were treated with CQCQD, and they were divided into two groups: earlytreated group (54 patients treated with CQCQD within 3 days after the onset of severe acute biliary pancreatitis) and latetreated group (36 patients treated with CQCQD between 3 and 7 days after the onset of severe acute biliary pancreatitis). The complication incidence rate, operation rate, mortality rate and hospitalization period were examined. Results: The incidence rates of encephalopathy, infection and gastrointestinal hemorrhage were lower in the earlytreated group than those in the latetreated group (P＜0.05）. The hospitalization periods of the early and latetreated groups were (24.9±18.4) days and (51.6±45.9) days respectively (P＜0.05）. The general mortality rate was 14.4%. The mortality rate of the earlytreated group (7.4%) was significantly lower as compared with that of the latetreated group (25.0%) (P＜0.05）. The operation rate of the earlytreated group (11.1%) was also significantly lower as compared with that of the latetreated group (27.8%) (P＜0.05）. Conclusion: Treating severe acute biliary pancreatitis with CQCQD in early stage may reduce the complication incidence