快速康复治疗方案对ICU重症急性胰腺炎的疗效观察

    Observation on the effect of rapid rehabilitation therapy on ICU severe acute pancreatitis

    • 摘要:
      目的探讨快速康复治疗方案在重症监护下重症急性胰腺炎治疗的临床效果。
      方法对96例重症急性胰腺炎病人的临床资料进行回顾性分析。其中2010年1月至2016年3月46例为对照组,采用传统方案治疗;2016年4月至2019年12月50例为观察组,在对照组基础上,联合包括充分镇痛、早期(24~72 h)经口或经鼻胃管进食、控制性液体复苏、尽早拔除鼻胃管、减少使用或尽早停用深静脉导管及导尿管、早期活动等快速康复治疗方案。比较2组治疗后疼痛评分、体质量下降、全身和局部并发症发生率、ICU住院时间、住院费用等情况。
      结果与对照组比较,观察组病人在ICU住院期间疼痛明显改善、总体并发症减少、输液时间缩短、治疗费用下降、ICU住院时间缩短(P<0.05~P<0.01),死亡率差异无统计学意义(P>0.05)。
      结论重症急性胰腺炎在重症监护下采用快速康复方案治疗安全有效,可以减少并发症,节约住院费用,缩短ICU住院时间,并改善病人生活品质,加快了病人康复;有望成为重症急性胰腺炎病人治疗的替代方法。

       

      Abstract:
      ObjectiveTo explore the clinical effect of rapid rehabilitation therapy on severe acute pancreatitis under intensive care.
      MethodsThe clinical data of 96 patients with severe acute pancreatitis were analyzed retrospectively.Forty-six cases from January 2010 to March 2016 were set as the control group, which was treated with traditional regimen; fifty cases from April 2016 to December 2019 were set as the observation group, which was treated with rapid rehabilitation therapy such as sufficient analgesia, early (24-72 h) oral or nasogastric tube feeding, controlled fluid resuscitation, early removal of nasogastric tube, reduction of use or early withdrawal of deep vein catheter and catheter, and early activity on the basis of control group.Pain score, body mass loss, incidence of systemic and local complication, ICU hospitalization time and hospitalization expense were compared between the two groups.
      ResultsCompared with the control group, the pain, overall complications, infusion time, treatment cost and ICU hospitalization time in the observation group were significantly improved (P < 0.05 to P < 0.01), and the mortality was not statistically significant (P>0.05).
      ConclusionsApplication of rapid rehabilitation therapy under the intensive care can reduce complication, save hospitalization expense, shorten ICU hospitalization time, improve the quality of life, and accelerate the recovery of patients with severe acute pancreatitis, which can be expected to become an alternative method for the treatment of patients with severe acute pancreatitis.

       

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