早期腹腔引流在重症急性胰腺炎治疗中的应用价值

The Values of Primary Peritoneal Catheter Drainage in the Treatment of Severe Acute Pancreatitis

目的:探讨早期腹腔置管引流在重症急性胰腺炎(SAP)治疗中的应用价值。方法:对64例重症急性胰腺炎伴腹腔大量积液的患者,早期行腹腔镜下灌洗置管引流10例及床旁穿刺置管引流54例。观察引流前后临床症状、腹部体征变化及并发症的发生率。结果:置管引流24h内,96.87%(62/64)的患者临床症状及腹部体征即出现不同程度的改善,全组病例均未发生穿刺相关并发症及继发腹腔感染。结论:腹腔灌洗和腹腔置管引流均能有效减少腹腔毒性液体,降低腹内压、促进胃肠道功能恢复、减少ACS等并发症的发生,是治疗SAP的一种微创、简便、安全、有效的手段。

Objective：To investigate the values of primary Peritoneal catheter drainage in the treatment of severe acute pancreatitis （SAP）. Methods：64 cases of severe acute pancreatitis with a large number of peritoneal fluid were included in the study.Of them,10 cases received the treatment of primary laparoscopic lavage and catheter drainage,and 54 cases underwent the percutaneous puncture and catheter drainage in the ward bed.Before and alter the drainage,the changes of clinical symptoms and abdominal signs,and the incidence of complications were observed.Results：With in 24h postoperatively, clinical symptoms and abdominal signs improved in varying degrees in the 96.87%（62/64）of patients.Puncture-related complications and secondary intra-abdominal infection have not occurred in our group.Conclusion：The peritoneal lavage and catheter drainage may effectively subside the toxicity of intra-abdominal fluid,reduce intra-abdominal pressure,promote resumption of gastrointestinal function,and decrease the occurrence of complications such as ACS.In conclusion,it is a minimally invasive,simple, safe and effective treatment alternative for SAR