暴发性急性胰腺炎并发腹腔高压综合征诊治体会

The Trentment Experionce of Fulminant Acute Pancreatitis Syndrome Complicated with Intra-abdominal Hypertension

目的:探讨暴发性急性胰腺炎并发腹腔高压综合征有效治疗方法。方法:1994年3月至2004年7月共收治SAP63例,其中FAP23例,FAP并发腹腔高压综合征者16例,对收治的16例暴发性胰腺炎并发腹腔高压综合征病人早期(发病后3d内)手术治疗与非手术治疗结果进行回顾性分析和总结。结果:16例暴发性胰腺炎并发腹腔高压综合征患者7例非手术治诊,其中轻度腹腔高压综合征3例,中度2例,重度2例,共死亡5例,死亡率达71.4%,3d内早期手术9例,其中轻度腹腔高压综合征1例,中度4例,重度4例,共死亡3例,死亡率达33.3%,两者比较有显著性差异。结论:暴发性急性胰腺炎并发轻度腹腔综合征者发病后早期尚可行积极的非手术治疗,而对已存在中、重度腹腔高压综合征者早期在积极采取非手术措施处理重症胰腺炎同时,宜尽早行有效的腹腔手术减压引流。

Objective： To study of the treatment of intra - abdominal hypertension syndrome secondary to fulminant acute pancreatitis. Method： We retrospectively analysed therapeutic results of LAHS to FAP during the 1994.03 to 2004.07. Result： There were 16 LAHS cases secondary to FAP during the period with morality rate of 71.4% （5/7）. Three out of the nine cases treated by early surgery died. The motality rate was 33.3% （3/9）, which was significantly different from that conserratively. Concluslon： Moderate to severe LAHS case secondany to fulminant acute pancreatitis shoud under exploration in the early phase of disease to improve the prognosis of FAP.