摘要
目的探讨早期腹腔置管灌洗在重症急性胰腺炎(SAP)治疗中的临床意义。方法选择我院2010年9月至2011年12月收治的SAP患者50例,随机分为早期腹腔置管灌洗组(25例)和常规治疗组(25例)。两组同时予以禁食水,胃肠减压,预防感染,补液,制酸抑酶等常规治疗,灌洗组在此基础上早期予以腹腔置管灌洗。比较两组治疗前及治疗第3天、第7天的C反应蛋白(CRP)水平、APACHEⅡ评分及中性粒细胞水平;以及两组全身炎症反应综合征(SIRS)持续时间、发生多器官功能障碍综合征(MODS)的器官数及病死率。结果两组CRP、APACHEⅡ评分及中性粒细胞值差异治疗前无统计学意义(P>0.05),治疗第3天比较差异有统计学意义(P<0.05),第7天比较存在更明显统计学差异(P<0.01);两组SIRS持续时间、发生MODS的例数、病死率比较差异有统计学意义(P<0.05)。结论早期腹腔置管灌洗术可以有效减少SAP的并发症和病死率。
Objective To explore the clinical significance of the early peritoneal lavage in severe acute pancre-atitis （SAP）. Methods Fifty patients with SAP from September 2010 to December 2011 were randomly divided into two groups： early peritoneal lavage group （n=25） and conventional methods group （n=25）. All patients were given conventional therapy, such as abrosia, gastrointestinal decompression, anti-infection, fluid infusion and suppressing gastric acid and trypsin. In addition to conventional thrapy, patients in lavage group were treated with early peritoneal lavage. The level of the CRP, APACHE Ⅱ score and NEU were compared between the two groups before treatment and 3, 7 d after treatment. The time of SIRS and the rates of MODS were also compared. Results There was no significant difference in the level of CRP, APACHE Ⅱ score and NEU before treatment between two groups （P〉0.05）. There were differences in the level of CRP, APACHE Ⅱ score, WBC, NEU 3 d after treatment （P 〈0.05） and more significant differences 7 d after treatment （P〈0.01）. The time of SIRS, the mortality and the rates of MODS were significantly different between two groups （P〈0.05）. Conclusion The early peritoneal lavage can significantly reduce complications and mortality in SAP.
出处
《肝胆胰外科杂志》
CAS
2013年第1期20-22,26,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
重症急性胰腺炎
腹腔灌洗
早期
疗效
severe acute pancreatitis
peritoneal lavage
early stage
curative effect
