CAJ | 학술논문

目的：探讨不同胃管置入长度对急性胰腺炎患者恢复的影响。方法选取2010年8月至2012年12月在我院治疗的急性水肿型胰腺炎患者63例，随机分成研究组（32例）与对照组（31例），两组患者入院后治疗措施与用药情况均相同，对照组胃肠减压时胃管置入从患者耳垂-鼻尖-剑突，长度范围45~55 cm，研究组从患者耳垂-鼻尖-剑突与肚脐连线中点(在之前基础上增加5~10 cm)。比较两组患者负压引出液体量、胃管阻塞情况、腹部疼痛减轻所需时间、血清淀粉酶（AMS）指标达到正常所需时间以及患者入院时间。结果研究组患者引出液体量在800 ml以上的比率显著高于对照组，两组比较差异具有显著统计学意义(P<0.01)；研究组未发生胃管阻塞，而对照组发生胃管阻塞的比率为12.9%，两组比较差异具有显著统计学意义(P<0.01)；研究组患者腹部疼痛减轻时间、血清淀粉酶达标时间及住院时间均比对照组明显缩短，差异具有统计学意义(P<0.05)。结论在常规胃管置入的基础上，根据患者年龄、身高等情况适当增加胃管置入长度，能有效提高急性胰腺炎胃肠减压效果，对减轻患者疾痛、促进患者早日恢复具有重要意义，值得临床借鉴。
목적：탐토불동위관치입장도대급성이선염환자회복적영향。방법선취2010년8월지2012년12월재아원치료적급성수종형이선염환자63례，수궤분성연구조（32례）여대조조（31례），량조환자입원후치료조시여용약정황균상동，대조조위장감압시위관치입종환자이수-비첨-검돌，장도범위45~55 cm，연구조종환자이수-비첨-검돌여두제련선중점(재지전기출상증가5~10 cm)。비교량조환자부압인출액체량、위관조새정황、복부동통감경소수시간、혈청정분매（AMS）지표체도정상소수시간이급환자입원시간。결과연구조환자인출액체량재800 ml이상적비솔현저고우대조조，량조비교차이구유현저통계학의의(P<0.01)；연구조미발생위관조새，이대조조발생위관조새적비솔위12.9%，량조비교차이구유현저통계학의의(P<0.01)；연구조환자복부동통감경시간、혈청정분매체표시간급주원시간균비대조조명현축단，차이구유통계학의의(P<0.05)。결론재상규위관치입적기출상，근거환자년령、신고등정황괄당증가위관치입장도，능유효제고급성이선염위장감압효과，대감경환자질통、촉진환자조일회복구유중요의의，치득림상차감。
Objective To explore the influence of different length of gastric tube on the recovery of patients with acute pancreatitis. Methods 63 patients with acute edema type pancreatitis in our hospital from August 2010 to December 2012 were randomly divided into research group (32 cases) and control group (31 cases). Patients from each group received the same treatment and medications. In control group, the length of gastric tube was measured fol-lowing the earlobe-tip-xiphoid sequence when the gastrointestinal decompression was carried out in patients. The length of gastric tube ranged from 45 cm to 55 cm. In the research group, the length of gastric tube was measured fol-lowing earlobe-tip-the attachment point of xiphoid and navel sequence (5-10 cm longer than the basic one). The liq-uid volume sucked by vacuum aspiration, gastric tube obstruction, time required to reduce the abdominal pain, time re-quired for serum amylase (AMS) to resume normal and patients' s hospitalization time in each group were compared. Results The ratio of liquid volume sucked by vacuum aspiration in the research group was more than 800 ml, which was significantly higher than that in control group (P<0.01). There was no gastric tube obstruction in research group, which was statistical significant than that in the control group (12.9%) (P<0.01). In research group, the time required to reduce the abdominal pain, the time required for serum amylase (AMS) to resume normal and the hospitalization time were significantly shorter than that in control group (P<0.05). Conclusions On the basis of conventional gastric tube placement, increasing the length of gastric tube according to patients' age, height and other conditions can effec-tively improve the effect of gastrointestinal decompression in acute pancreatitis patients. Moreover, it is helpful to ease the pain and promote the recovery of patients.