静脉导管置管在治疗重症急性胰腺炎中的作用

Clinical Study of Indwelling Catheters in Patients with Severe Acute Pancreatitis

目的探讨静脉导管置管引流在治疗重症急性胰腺炎(SAP)中的作用。方法2002年8月至2004年5月我院共收治SAP患者113例,根据治疗方式不同分为静脉导管腹腔引流组(简称静脉导管组,45例)和常规治疗组(68例),两组常规治疗一致。比较两组患者的疗效和APACHEⅡ评分,并监测腹腔引流和腹内压情况。结果两组患者在性别、年龄及入院时APACHEⅡ评分方面差异均无显著性意义(P>0.05)。治疗后第2天和第5天,静脉导管组的APACHEⅡ评分明显低于常规治疗组(P=0.000)。静脉导管组的住院时间明显缩短(P=0.000),囊肿发生率低于常规治疗组(P=0.000),死亡率(8.9%)与常规治疗组(19.1%)间差异无统计学意义(P>0.05)。静脉导管组的腹内压与腹腔引流量、住院时间及APACHEⅡ评分均呈正相关,相关系数分别为0.552、0.748和0.923,P=0.000。结论静脉导管置管引流在治疗重症急性胰腺炎中有重要作用。

Objective To study the therapeutic effects of indwelling catheters in patients with severe acute pancreatitis (SAP). Methods The clinical data of 113 patients with severe acute pancreatitis admitted to our hospital from Aug. 2002 to May 2004 were collected. The patients were divided into the indwelling catheter group (45 cases) and the control group (68 cases).The APACHEⅡscores and therapeutic results were compared. The drainage and intraabdominal pressure (IPA) were monitored. Results The APACHEⅡscores on day 2 and day 5 after therapy in indwelling catheter group were significantly decreased compared with the control group(P=0.000).The average hospital stay and cyst morbidity of the indwelling catheter group were significantly decreased compared with those of the control group(P=0.000). The mortality rate was lower in the indwelling catheter group, but there was no statistical difference between these two groups(P>0.05). The IAP was positively correlative with the drainage volume, hospital day and APACHEⅡscores(r=0.552, r=0.748, r=0.923,P=0.000). Conclusion The indwelling catheter is an important treatment in patients with SAP.