论著

血清降钙素原与中性粒细胞淋巴细胞比率对急性胰腺炎继发急性肺损伤的预测价值

The value of serum procalcitonin levels and neutrophil-to-lymphocyte ratio (NLR) in predicting acute lung injury secondary to acute pancreatitis

:60-63
 
目的 探讨血清降钙素原(PCT)与中性粒细胞淋巴细胞比率(NLR)对预测急性胰腺炎(AP)继发急性肺损伤(ALI)的临床适用性。方法 回顾性分析60个AP病例,对合并ALI的实验组和没有合并ALI的对照组治疗前后血清PCT和NLR进行均数比较、相关性分析、ROC分析等统计分析。结果 两组间治疗前NLR(P=0.019)与治疗期间血清PCT平均值(P<0.001)有统计学差异,ROC分析:治疗前NLR、治疗期间血清PCT平均值对于预测ALI的灵敏度、特异度、约登指数分别为0.778、0.889;0.690、0.881;0.468、0.77,两者的差异有统计学意义(P=0.0134)。结论 急性胰腺炎早期治疗前,NLR对于预测ALI有一定的参考价值,而在急性胰腺炎后期,治疗期间的血清PCT平均值对于预测ALI有着良好的灵敏度和特异度,具有一定的临床适用性。
Objective To investigate the clinical applicability of serum procalcitonin levels and neutrophil-to-lymphocyte ratio (NLR) in predicting acute lung injury(ALI) secondary to acute pancreatitis(AP). Methods Sixty cases of AP were recruited to explore their serum-PCT and NLR before/after treatment. Means comparison, correlation analysis, ROC analysis were carried out. Results The NLR before treatment (P=0.019)and serum-PCT after treatment(P<0.001)were statistical significance of two groups(ALI、NON-ALI). In ROC analysis, the sensitivity, specificity, Jorden index of above two index were 0.778、0.889;0.690、0.881;0.468、0.77 respectively. There were statistically significant differences between them(P=0.0134). Conclusion In the early phase before treatment in AP, NLR has certain reference value in predicting ALI. On the other hand, in the later phase after treatment in AP, serum-PCT has great sensitivity, specificity and clinical applicability.
综述

大柴胡汤合大承气汤在急性胰腺炎治疗中的研究进展

Research progress on Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis

:252-259
 
       急性胰腺炎(AP)是一种常见的消化系统急症。随着生活水平的提高,其重症发病率也逐年增加。中西医结合治疗急性胰腺炎在临床实践中展现出优势。近年来,大柴胡汤合大承气汤在治疗急性胰腺炎方面药理机制的研究不断延伸,同时对方药中的药理活性成分也在不断深入研究。该文旨在整理相关研究,综述大柴胡汤合大承气汤治疗急性胰腺炎的理论基础、临床应用、药物活性成分、药理机制等,以期为临床实践和进一步深入研究提供参考。
        Acute pancreatitis(AP)is a common gastrointestinal emergency.With the improvement of living standards,the incidence of severe AP has been increasing year by year.The combined treatment of traditional Chinese and Western medicine has shown advantages in the clinical practice of acute pancreatitis.In recent years,the pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis has been continuously studied,and the pharmacological active components in the prescription are also being explored.This article aims to summarize  relevant  research on the theoretical basis,clinical application,active ingredients and pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis,providing reference for clinical practice and further research.
护理研究

基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响

The impact of micro video based nursing interventions on disease awareness,self-management and compliance behavior in patients with acute pancreatitis

:125-130
 
       目的   探讨基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响。方法   根据中心随机法将郑州大学第二附属医院2021年1月—2023年1月收治的88例急性胰腺炎患者作为研究对象,其中传统组44例给予常规干预,微视频组44例在传统组的基础上结合微视频的护理干预,比较两组患者疾病知晓情况、自我管理能力和遵医行为情况。结果   干预2个月后,微视频组病例脱落3例,传统组病例脱落4例,两组疾病知晓各维度高于干预前,且微视频组高于传统组,其中疾病病因(t=3.151,P=0.003)、临床症状(t=7.165,P<0.001)、并发症(t=5.497,P<0.001)、如何预防疾病复发(t=8.195,P<0.001);两组自我护理能力量表(ESCA)各维度评分高于干预前,且微视频组高于传统组,其中各维度评分结果为自我护理技能(t=2.787,P=0.007)、自我概念(t=2.272,P=0.026)、自护责任感(t=2.644,P=0.011)、健康知识水平(t=3.321,P=0.001);两组遵医行为各维度评分高于干预前,且微视频组高于传统组,其中各维度评分结果为饮食依从性(t=6.271,P<0.001)、用药依从性(t=3.539,P=0.001)、锻炼依从性(t=4.469,P<0.001)、定期复查(t=2.764,P=0.007)。结论   通过运用微视频的护理干预能够提高急性胰腺炎患者疾病知识的掌握,促进机体自我管理水平的恢复,进而提高遵医行为。
       Objective  To explore the impact of micro video based nursing interventions on disease awareness,self-management and compliance behavior in patients with acute pancreatitis.Methods  According to the central randomization method,88 patients with acute pancreatitis admitted to the Second Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were selected as the research subjects.Among them,44 patients in the traditional group received routine intervention,and 44 patients in the micro video group received nursing intervention combined with micro video on the basis of the traditional group.The disease awareness,self-management ability and compliance behavior of the two groups of patients were compared.Results  After two months of intervention,three cases were dropped out in the micro video group and four cases were dropped out in the traditional group.The disease awareness in both groups was higher than that before intervention,and the micro video group was higher than the traditional group,including disease etiology(t=3.151,P=0.003),clinical symptoms(t=7.165,P<0.001),complicationst=5.497,P<0.001) and how to prevent disease recurrence(t=8.195,P<0.001).The scores of ESCA in both groups were significantly higher than those before intervention,and the micro video group was higher than the traditional group in terms of self-care skills(t=2.787,P=0.007),self-concept(t=2.272,P=0.026),self-care responsibility(t=2.644,P=0.011) and health knowledge level(t=3.321,P=0.001).The scores of all dimensions of compliance behavior in both groups were significantly higher than those before intervention,and the micro video group had higher scores than the traditional group in terms of dietary compliancet=6.271,P<0.001),medication compliance(t=3.539,P=0.001),exercise compliance(t=4.469,P<0.001) and  regular follow-up(t=2.764,P=0.001).Conclusions  The use of micro video nursing interventions can improve the mastery of disease knowledge in patients with acute pancreatitis,promote the recovery of the body’s self-management level,and thereby improvemedical compliance behavior.
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