早期应用柴芩承气汤治疗重症急性胰腺炎并发急性呼吸窘迫综合征.docVIP

早期应用柴芩承气汤治疗重症急性胰腺炎并发急性呼吸窘迫综合征 　［摘要］ 目的 探讨早期应用柴芩承气汤治疗重症急性胰腺炎（severe acute pancreatitis，SAP）并发急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）的疗效。方法 依据纳入和排除标准，选取我院中西医结合科收治的SAP患者40例，按1∶1随机分成早期组（20例）和晚期组（20例），早期组入院时便应用柴芩承气汤治疗；晚期组入院3天后加用柴芩承气汤治疗。结果 两组患者入院时Ranson评分、CT评分、APACHEⅡ评分差异无显著性（P＞0.05），治疗7天后早期组APACHEⅡ评分（5.1±2.0）分，明显低于晚期组（9.3±4.3）分（P＜0.01）；早期组并发休克（1/20）明显低于晚期组（7/19）（P＜0.05）；早期组ARDS、肾功能衰竭、休克、心功能不全、肝功能不全及肠麻痹持续时间及住院病程短于晚期组（P＜0.05）；早期组手术中转率低于晚期组（P＜0.05）；但感染发生率和死亡率差异无显著性（P＞0.05）。结论 早期应用柴芩承气汤治疗SAP，可缩短并发症的持续时间及病程，降低手术中转率，但对感染发生率和死亡率的影响，有待于扩大样本量的进一步研究。 ［关键词］ 重症急性胰腺炎；急性呼吸窘迫综合征；柴芩承气汤；临床研究 Clinical study of severe acute pancreatitis complicating with acute respiratory distress syndrome treated by Chaiqin Chengqi Decoction in early stage ［Abstract］ Objective To investigate the therapeutic effects of severe acute pancreatitis（SAP）complicating with acute respiratory distress syndrome（ARDS） treated by Chaiqin Chengqi Decoction （CQCQD） in early stage.Methods The randomized controlled method was adopted.40 patients with SAP complicating with ARDS were randomized in to early-treated group （20 cases were treated by CQCQD as soon as who entered hospital） and late-treated group （20 cases were treated by CQCQD after 3 days from who had entered hospital）.Analyzing the incidences of complications，infection，need of operation and mortality，the duration of complications and the hospitalization period.Results The Ranson score，CT score，Acute Physiology and Chronic Heath EvaluationⅡscore （APACHEⅡ score） and the incidences of ARDS，renal failure，cardiac inadequacy，encephalopathy，hepatic failure and enteroplegia were no statistical difference in the two groups（P＞0.05）in the early stage of hospitalization.But the APACHEⅡ score （5.05±2.04）in early-treated group was lower than those in late-treated group（9.26±4.28）（P＜0.01）after 7 days.The duration of ARDS，renal failure，cardiac inadequacy，hepatic failure and enteroplegia were shorter in early-treated group than those in late-treated group（P＜0.05）.