内镜监视下置管腹膜透析在重症急性胰腺炎治疗中的应用及护理

The application and nursing of peritoneal dialysis by intubating with endoscope for serve acute pancreatitis

目的探讨腹膜透析对重症急性胰腺炎（SAP）的疗效及护理。方法选择2004年1月～2007年3月在我院接受治疗的60例SAP患者作为研究对象，其中以施行腹膜透析的28例患者作为治疗组，以未行腹膜透析的32例患者作为对照组，两组患者入院情况基本相似。两组患者除腹膜透析外，均接受相同的常规治疗。比较两组治疗前后的血淀粉酶值、血白细胞计数、血Ca^2＋度、血氧分压（PaO2）、腹痛腹胀缓解时间、住院时间、治愈率。重症急性胰腺炎患者置管腹膜透析术前、术中、术后均给予高质量的护理。结果治疗组的血淀粉酶值与对照组比较，两组的好转趋势不同，治疗组优于对照组。血白细胞计数、血Ca^2＋浓度、血氧分压（PaO2）、腹痛腹胀缓解时间、住院时间均优于对照组。结论腹膜透析能明显减轻SAP患者的一般情况，改善患者预后，值得临床推广应用。高质量的腹膜透析护理是治疗重症急性胰腺炎的重要因素之一。

Objective To investigate the therapeutic effect of peritoneal dialysis by intubating with endoscope for serve acute pancreatitis （SAP） . Methods 60 cases SAP were selected from January 2004 to March 2007 in the people＇s hospital of shenzhen, whose pathogenetic condition was similar. Peritoneal dialysis was applied for 28 cases SAP. And the other 32 cases SAP was control group. All SAPs were treated by the standard conventional model of therapy. Amylase, WBC count, Ca^2＋, PaO2 in peripheral blood before and after treatment at 1 , 2 , 3 day were detected. The time of becoming normal of amylase, WBC count, Ca^2＋, PaO2 in blood , the release time of abdominal pain , abdominal distension, average time of hospital stay , cure rate were observed. All these indexs were compared between the two groups. The patients of treatment group were given high - quaihy nursing before, at and after operation. Results After peritoneal dialysis , amylase, WBC count, Ca^2＋ , PaO2 in blood in the first , second , and third day taken a favorable turn than before treatment. The treatment group was better than control group. Compared to the control group , amylase, WBC count, Ca^2＋ , PaO2 in blood , the release time of abdominal pain and abdominal distension, average time of hospital stay , cure rate in treatment group were statistically reduced. It also discovered the imporntance of high - quailty nursing in the therapeutic effect of peritoneal dialysis for serve acute pancreatitis in the treatment group. Conclusion The PD methed is easy, quick, small trauma, few complicated and can improve the pathogenetic condition in patients with early SAP , so it will be of great value in wide - ranging application and further studied. Meanwhile, the high - quaihy nursing plays an important role in the therapy of peritoneal dialysis for serve acute pancreatitis.