联合血液滤过、腹腔镜等治疗急性重症胰腺炎

Treatment of severe acute pancreatitis by hemofiltration combined with laparoscope

目的探讨联合血液滤过、腹腔镜下置管引流和丹参治疗急性重症胰腺炎(SAP)的价值。方法30例SAP患者分为两组,A组20例行常规治疗,同时施行血液滤过、腹腔镜下置管引流,应用施他宁和丹参等扩张胰腺微循环药物;B组10例仅采用常规治疗(支持治疗,应用抑制胰腺分泌药,如施他宁、胰酶抑制剂及抗生素等),分别观察TNF、IL-6、IL-8、Balthazar CT积分、APACHEⅡ积分。结果A组TNF、IL-6、IL-8、Balthazar CT积分、APACHEⅡ积分较B组显著降低(P<0.05)。病死率A组为15%,B组为30%。结论联合血液滤过、腹腔镜等方法治疗SAP可提高SAP的治愈率。

Objective To explore the value on the treatment of severe acute pancreatitis （SAP） by hernofiltration combined with Dan Sen and catheterizing drainage through laparoscope. Methods Thirty patients of SAP were divided into two groups. On the basis of routine treatment（supportive treatment, suppressing excrine of pancreas stilamin, trypsin inhibitor and antibiotics）, hemofiltration, catheterizing drainage,stilamin and Dan Sen were added in group A,while only routine treatment were administered in group B. TNF, IL- 6, IL- 8, score of Balthazar CT and score of APACHE Ⅱ were studied in both groups. Results The value of TNF, IL-6,IL-8,seore of Balthazar CT and score of APACHE Ⅱ in group A were significantly lower than those in group B（ P 〈 0.05）. The morbidity in group A was 15% ,while 30% in group B. Conclusions The methods of hemofiltration,Dan Sen and catheterizing drainage through laparoseope can increase the cure rate of SAP.