Retention enema with rhubarb for the treatment of severe acute pancreatitis with intestine paralysis

Chu-Ming Yuan ,Yi-Lian Li ,Shiyong Chen ,Xiaolong Wu ,Shuanglun Xie ,Haixin Chen

doi:10.3760/cma.j.issn.1674-1935.2011.06.003

Abstract

Objective To investigate the efficacy of retention enema with rhubarb for severe acute pancreatitis (SAP) with intestine paralysis.Methods Totally 60 patients with SAP since last five years were included,and then they were randomly divided into control group and treatment group with 30 patients in each group.Patients in control group received routine treatment of SAP,including fasting,gastrointestinal decompression,antibiotics,inhibition of pancreatic secretion,inhibition of SIRS and organ support.Patients in treatment group received additional retention-enema with rhubarb (200mL soak solution by 100g rhubarb),once daily until the recovery of bowel function.The bladder pressure ( the 1,2,5 and 6 days after admission)was evaluated,and APACHE Ⅱ score was determined.The recovery of bowel function ( the bowel sounds,the flatus and defecation of intestinal tract),SIRS recovery time,hospital stay,and the mortality were observed.Results At the 5 and 6 days after admission,the bladder pressure and APACHE Ⅱ score in treatment group were significantly lower than those in control group [ (21.9 ±9.0)cmH2O vs (25.3 ±9.5)cmH2O,( 16.5 ±7.5)cmH2O vs (20.6 ±7.7)cmH2O,1 cmH2O =0.098 kPa; (9.8 ±3.8) vs (12.5 ±3.6),(9.2 ±2.4)vs ( 11.2 ± 2.5 ),P ＜ 0.05 ) ].The recovery time of bowel function and SIRS recovery time,hospital stay,and the mortality in treatment group were ( 126.8 ± 28.2 ) h,( 131.2 ± 29.6) h,( 25.6 ± 6.2) d and 16.7 ％,and the recovery time of bowel function and SIRS recovery time,hospital stay were significantly lower than those in control group [ ( 169.9 ± 53.4 ) h,( 160.4 ± 30.4) h,( 33.2 ± 6.4) d,P ＜ 0.05 ).The mortality was reduced,but the difference between the two groups was not statistically significant ( 26.7％,P ＞ 0.05 ).Conclusions The retention-enema with rhubarb can accelerate the recovery time of bowel function of SAP patients and reduce the hospital stay. Key words: Pancreatitis, acute necrotizing ; Rhubarb; Enema; Change of bladder pressure

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