腹腔置管灌洗治療重癥急性胰腺炎腹腔間隔綜合征的療效觀察

[摘要] 目的 探討腹腔置管灌洗治療重癥急性胰腺炎（SAP）并發腹腔間隔室綜合征（ACS）的臨床療效。 方法 選取我院2012年1月～2013年5月70例SAP并發ACS患者的資料，根據患者治療方式分為觀察組及對照組，各35例，對照組采用開腹探查引流術治療，觀察組采用腹腔置管灌洗治療，對兩組患者的治療效果及并發癥進行評價。 結果 觀察組患者病程短，與對照組患者比較差異有統計學意義（P<0.05）。兩組患者在顯效率、并發癥發生率及死亡率等方面比較，差異無統計學意義（P>0.05）。 結論 腹腔置管灌洗治療SAP并發ACS，能有效阻斷炎性介質對組織器官的損害，并迅速降低腹腔內壓力，并發癥少，是一種有效簡單的治療措施，值得在臨床推廣。

[關鍵詞] 重癥胰腺炎；腹腔置管灌洗；腹腔間隔綜合征；臨床療效

[中圖分類號] R656 [文獻標識碼] A [文章編號] 2095-0616（2013）13-18-02

Curative effect observation of abdominal cavity set tube lavage in treatment of abdominal compartment syndrome in severe acute pancreatitis

LIU Yuqing ZHANG Lin CHEN Dingguang YANG Dongming

Department of General Surgery，Huizhou City Hospital of Traditional Chinese Medicine，Guangdong Province，Huizhou 516001，China

[Abstract] Objective To study the curative effect of abdominal cavity set tube lavage in treatment of abdominal compartment syndrome in severe acute pancreatitis. Methods 70 cases of SAP patients complicated with ACS in our hospital from January 2012 to May 2012 were selected and divided into observation group and control group according to the patient's treatment methods，35 cases of each group. Control group were given the open probe drainage treatment，observation group abdominal cavity set tube lavage treatment， therapeutic effect and complications of two groups were evaluated. Results Compared with the control group，the observation group had shorter duration，there was statistically significant difference（P<0.05）.The excellence rate，incidence of complications and mortality rate of two groups had no significant difference （P>0.05）. Conclusion Abdominal cavity set tube lavage in treatment of abdominal compartment syndrome in severe acute pancreatitis can effectively block the damage to the tissues and organs of inflammatory medium， quickly reduce intra-abdominal pressure，with fewer complications， and is an effective and simple treatment method，worth of clinical promotion.

[Key words] Severe acute pancreatitis；Abdominal cavity set tube lavage；Abdominal compartment syndrome； Clinical curative effect

重癥急性胰腺炎（severe acute pancreatitis，SAP）常伴腹內壓升高，升高到一定程度，會導致心、肺、腎、胃腸功能障礙甚至衰竭，1984年Kron首次將這種腹內壓升高合并器官功能障礙定義為腹腔間隙綜合征（abdominal compartment syndrome，ACS），其病情兇險[1]，處理較為復雜，病死率高達50%～75%，開腹減壓在SAP并發ACS的治療中應用越來越廣泛，但開腹減壓搶救大量ACS患者生命的同時，也帶來了許多棘手的并發癥，我院近年來采用早期局麻下行腹腔置管灌洗術治療SAP并發ACS，取得了良好的效果，現報道如下。

1 資料與方法

1.1 一般資料

選擇我院2012年1月～2013年5月70例SAP并發ACS患者的資料，根據治療方式分為觀察組及對照組，各35例，觀察組男22例，女13例，年齡21～75歲，平均（54.4±3.4）歲；對照組男24例，女11例，年齡23～76歲，平均（52.3±5.3）歲。……