手术前应用芒硝外敷可减轻轻度急性胆源性胰腺炎的炎症反应，促进康复。

External application of mirabilite before surgery can reduce the inflammatory response and accelerate recovery in mild acute biliary pancreatitis.

机构信息

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.

Department of Hepatobiliary Surgery, Suining Hospital of Traditional Chinese Medicine, Suining city, Sichuan Province, 629000, China.

出版信息

BMC Gastroenterol. 2023 Aug 2;23(1):264. doi: 10.1186/s12876-023-02901-5.

DOI:10.1186/s12876-023-02901-5

PMID:37532999

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10394763/

Abstract

OBJECTIVE

Mild acute biliary pancreatitis (MABP) is one of the most common diseases that require surgical treatment. Previous studies have focused on the timing of laparoscopic cholecystectomy (LC) for MABP. However, the impact of its inflammatory response process on the clinical outcome has been rarely reported. This study aimed to investigate the effect of preoperative external application of mirabilite on the inflammatory response and clinical efficacy in MABP.

METHODS

Medical records of patients undergoing LC due to MABP from November 2017 to June 2022 were retrospectively reviewed. Prior to surgery, the control group received the same baseline treatment measures as the study group. The difference was the addition of external application of mirabilite in the study group.

RESULTS

A total of 75 patients were included in the final analysis: 38 patients in the mirabilite group and 37 patients in the control group. Repeated-measures ANOVA (P < 0.01) showed that the white blood cell count (WBC) on the 3rd day of admission and the WBC and C-reactive protein (CRP) level on the 5th day of admission decreased rapidly and significantly in the mirabilite group, compared with the control group. The mirabilite group had earlier anal exhaust time. The number of patients in the mirabilite group and control group with gallbladder wall ≥ 3 mm before the operation was 16 (42.11%) vs. 24 (64.86%), p = 0.048, respectively; and the number of cases with surgical drain placement was 2 (5.26%) vs. 9 (24.32%), p = 0.020, respectively. The intraoperative modified American Fertility Society (mAFS) score of adhesions was lower in the mirabilite group (1.08 ± 0.59 points) than in the control group (1.92 ± 0.60 points), p = 0.000. The mirabilite group, compared to the control group, p = 0.000, had a short waiting time for surgery (5.68 ± 0.70 days vs. 6.54 ± 0.59 days), short operation time (38.03 ± 5.90 min vs. 48.51 ± 8.37 min), and reduced hospitalization time (8.95 ± 0.96 days vs. 9.84 ± 1.07 days).

CONCLUSION

This study demonstrated that preoperative external application of mirabilite can reduce the inflammatory response, decrease the edema and peribiliary adhesions at the surgical site, and accelerate recovery in MABP.

摘要

目的

轻度急性胆源性胰腺炎（MABP）是最常见需要手术治疗的疾病之一。既往研究主要集中在腹腔镜胆囊切除术（LC）治疗 MABP 的时机上。然而，其炎症反应过程对临床结局的影响很少有报道。本研究旨在探讨术前应用芒硝外敷对 MABP 炎症反应和临床疗效的影响。

方法

回顾性分析 2017 年 11 月至 2022 年 6 月因 MABP 行 LC 的患者病历资料。手术前，对照组接受与研究组相同的基础治疗措施。研究组在此基础上加用芒硝外敷。

结果

最终共有 75 例患者纳入最终分析：芒硝组 38 例，对照组 37 例。重复测量方差分析（P<0.01）显示，芒硝组患者入院第 3 天的白细胞计数（WBC）和第 5 天的 WBC 和 C 反应蛋白（CRP）水平下降迅速且明显低于对照组。芒硝组患者肛门排气时间更早。术前芒硝组和对照组胆囊壁≥3mm 的患者分别为 16 例（42.11%）和 24 例（64.86%），p=0.048；手术引流放置的患者分别为 2 例（5.26%）和 9 例（24.32%），p=0.020。芒硝组术中改良美国生育协会（mAFS）粘连评分（1.08±0.59 分）低于对照组（1.92±0.60 分），p=0.000。与对照组相比，芒硝组的手术等待时间更短（5.68±0.70 天 vs. 6.54±0.59 天），手术时间更短（38.03±5.90 分钟 vs. 48.51±8.37 分钟），住院时间更短（8.95±0.96 天 vs. 9.84±1.07 天）。