腹腔灌洗治疗重症急性胰腺炎的疗效观察(1)
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【摘要】 目的 探讨腹腔灌洗治疗重症急性胰腺炎(SAP)的疗效。方法 回顾性分析我院2002年5月至2008年1月45例SAP患者,其中行腹腔灌洗治疗23例,采用双导管置入腹腔灌洗治疗,与同期未行腹腔灌洗的22例进行对比观察,比较两组间的疗效。结果 腹腔灌洗组的腹痛、腹胀缓解时间、住院时间较未灌洗组明显缩短(P<0.01)。APACHEⅡ评分较未灌洗组明显改善(P<0.05)。腹腔灌洗组急性肾衰、ARDS、休克、感染的总发生率显著低于未灌洗组(P<0.05)。腹腔未灌注组病死率(27.3%)显著高于腹腔灌注组(P<0.01)。结论 及时行腹腔灌洗是提高SAP治疗效果,减少并发症发生率,降低死亡率的有效措施。
【关键词】重症急性胰腺炎;腹腔灌洗
Observation of the effect on treatment of Peritoneal Lavage in Patients with Severe Acute Pancreatitis
YUE Jing.Department of Gastroenterology,WeiHai municipal hospital,ShanDong 264200,China
【Abstract】 Objective To study the therapeutical effectof Peritoneal Lavage in Patients with Severe Acute Pancreatitis.Methods By retrospective fourty fiveSAP patients from May 2002 to January 2008 were enrolled,and 23 patients were chosen for peritoneal lavage by dual lumen catheter,22 patients received routine treatment only were taken as the control group.The therapeutical effect was compared in two groups.Results After peritoneal lavage,The time for abdominal pain reliefand abdominal distention,average days of hospitalization was significantly shorter in the peritoneal lavage group than that in the control group(P<0.01).The APACHE Ⅱscores decrease,hyperamylasemiawas shorter in the peritoneal lavage group than that in the control group(P<0.05).The total incidence of complications including acute renal failure,ARDS,SHOCK,infected,case fatalitywas lower in the peritoneal lavage group than that in the control group.Conclusion To raise the therapeutical effect,decrease the incidence of complications and mortalityin patients with Severe Acute Pancreatitis,Peritoneal Lavage in time was autility meas.
【Key words】Severe Acute Pancreatitis ; Peritoneal Lavage
重症急性胰腺炎(SAP)是一种伴有全身炎症反应综合征(SIRS)的急腹症,发病急骤,并发症多,死亡率高。20世纪80年代其死亡率为50%以上,虽经20多年的理论研究与临床实践,治疗方法不断提高,死亡率仍达20%~30%[1,2]。因此,早期诊断并选择合理的治疗方法,对改善预后有重要意义。本文回顾性总结了我院自2002年5月至2008年1月收治的SAP患者45例,其中行腹腔灌洗治疗23例,取得了满意的临床效果,现分析报告如下。
1 资料与方法
1.1 一般资料 本组45例患者中,男27例,女18例,年龄21~65岁,平均(55±2.9)岁,均符合中华医学会消化病学分会胰腺病学组制定的SAP诊断标准[3]。病因:胆源性22例,酒精性16例,暴饮暴食5例,原因不明2例。45例患者中行腹腔灌洗治疗23例做为治疗组,余22例设为对照组,两组在性别、年龄、发病诱因、腹部症状、疾病严重度评分等方面差异无统计学意义 ......
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