Jun-Jun Sun, Zhi-Jie Chu, Wei-Feng Liu, Shi-Fang Qi, Yan-Hui Yang, Peng-Lei Ge, Xiao-Hui Zhang, Wen-Sheng Li, Cheng Yang, Yu-Ming Zhang, Department of General Surgery, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan Province, China.
World J Gastroenterol. 2013 Dec 14;19(46):8752-7. doi: 10.3748/wjg.v19.i46.8752.
To investigate effects of perirenal space blocking (PSB) on gastrointestinal function in patients with severe acute pancreatitis (SAP).
Forty patients with SAP were randomly allocated to receive PSB or no PSB (NPSB). All the SAP patients received specialized medical therapy (SMT). Patients in the PSB group received PSB + SMT when hospitalized and after diagnosis, whereas patients in the NPSB group only received SMT. A modified gastrointestinal failure (GIF) scoring system was used to assess the gastrointestinal function in SAP patients after admission. Pain severity (visual analog scale, 0 to 100) was monitored every 24 h for 72 h.
Modified GIF score decreased in both groups during the 10-d study period. The median score decrease was initially significantly greater in the PSB group than in the NPSB group after PSB was performed. During the 72-h study period, pain intensity decreased in both groups. The median pain decrease was significantly greater in the PSB group than in the NPSB group at single time points. Patients in the PSB group had significantly lower incidences of hospital mortality, multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection, and stayed in the intensive care unit for a shorter duration. However, no difference in terms of operation incidence was found between the two groups.
PSB could ameliorate gastrointestinal dysfunction or failure during the early stage of SAP. Moreover, PSB administration could improve prognosis and decrease the mortality of SAP patients.
研究肾周间隙阻断（PSB）对重症急性胰腺炎（SAP）患者胃肠功能的影响。
将 40 例 SAP 患者随机分为 PSB 组和非 PSB 组（NPSB 组）。所有 SAP 患者均接受专科治疗（SMT）。PSB 组患者在住院后及确诊后接受 PSB+SMT，NPSB 组患者仅接受 SMT。采用改良胃肠衰竭评分系统评估 SAP 患者入院后的胃肠功能。疼痛严重程度（视觉模拟评分，0-100）每 24 小时监测一次，共 72 小时。
两组在 10 天的研究期间，改良 GIF 评分均下降。PSB 组在 PSB 后初始阶段的评分下降中位数明显大于 NPSB 组。在 72 小时的研究期间，两组的疼痛强度均下降。PSB 组在各时间点的疼痛下降中位数均明显大于 NPSB 组。PSB 组患者的住院死亡率、多器官功能障碍综合征、全身炎症反应综合征和胰腺感染发生率较低，在重症监护病房停留时间较短。然而，两组的手术发生率无差异。
PSB 可改善 SAP 早期的胃肠功能障碍或衰竭。此外，PSB 治疗可改善 SAP 患者的预后，降低死亡率。
