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.doc

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1、临床医学论文-早期应用柴苓承气汤治疗胆源性重症急性胰腺炎的临床硏究作者：薛平，黄宗文，郭佳，赵健蕾，李永红，王忠朝，胆源性重症急性胰腺炎〔摘要〕日的：探讨早期应用柴苓承气汤治疗胆源性重症急性胰腺炎（severeacutepancreatitis,SAP）的疗效。方法：90例符合病例选择标准并接受柴苓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（3d内入院接受治疗，54例）和晚期组（3〜7d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

2、的发生率明显低于晩期组（PV0.05）。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），早期组和晩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：早期应用柴苓承气汤治疗胆源性SAP，可减少并发症的发生、缩短住院时间、减少手术屮转率及降低病死率。〔关键词〕胆源性重症急性胰腺炎；柴苓承气汤；临床硏究ClinicalstudyofChaiqinChengqi

3、Decoctionintreatingsevereacutebi1iarypancreatilisABSTRACTObjective:TostudythetherapeuticeffectsofChaiqinChengqiDecoction(CQCQD)intreatingsevereacutebi1iarypancreatitis

4、ogroups:earlytreatedgroup(54patientsIreatedwithCQCQDwithin3daysaftertheonsetofsevereacutebi1iarypancreatitis)andlatctreatedgroup(36patientstreatedwithCQCQDbetween3and7daysaftertheonsetofsevereacutebi1iarypancreatitis)・Thecomplicationincidencerate,operationrate,mortalit

5、yrateandhospitaiizationperiodwereexamined.Results:Theincidenceratesofencephalopathy,infectionandgastrointestinalhemorrhagewere1owerintheearlytreatedgroupthanthoseinthelatctreatedgroup(P<0.05)・Thehospitaiizationperiodsoftheearlyandlatetreatedgroupswere(24.9±18.4)daysand

6、(51.6±45.9)daysrespectively(P<0.05)・Thegeneralmortalityratewas14.4%.Themortalityrateoftheearlytreatedgroup(7.4%)wassignificantly1owerascomparedwiththatoftheIntelreatedgroup(25.0%)(P<0.05).Theopcrationrateoftheearlytreatedgroup(11.1%)wasalsosignificantly1owerascomparedw

7、iththatofthelatetreatedgroup(27.8%)(P<0.05)・Conclusion:Treatingsevereacutebi1iarypancreatitiswithCQCQDinearlystagemayreducethecomplicationincidencerate,shortenthehospitaiizationperiod，anddecreaseIheoperationrateandmortalityrate.KEYWORDSsevereacutebi1iarypancreatitis;Ch

8、aiqinChengqiDecoction;clinicalstudies重症急性胰腺炎(severeacutepancreatitis,SAP)是常见的外科急腹症之一，国内报道胆道疾病是其发病的主要诱因，约占60%〔1〕。有学者认为