腹腔灌洗治疗重症急性胰腺炎的疗效观察

Observation of the effect on treatment of Peritoneal Lavage in Patients with Severe Acute Pancreatitis

目的探讨腹腔灌洗治疗重症急性胰腺炎（SAP）的疗效。方法回顾性分析我院2002年5月至2008年1月45例SAP患者，其中行腹腔灌洗治疗23例，采用双导管置入腹腔灌洗治疗，与同期未行腹腔灌洗的22例进行对比观察，比较两组间的疗效。结果腹腔灌洗组的腹痛、腹胀缓解时间、住院时间较未灌洗组明显缩短（P〈0．01）。APACHEII评分较未灌洗组明显改善（P〈0．05）。腹腔灌洗组急性肾衰、ARDS、休克、感染的总发生率显著低于未灌洗组（P〈0．05）。腹腔未灌注组病死率（27．3％）显著高于腹腔灌注组（P〈0．01）。结论及时行腹腔灌洗是提高SAP治疗效果，减少并发症发生率，降低死亡率的有效措施。

Objective To study the therapeutical effect of Peritoneal Lavage in Patients with Severe Acute Pancreatitis. Methods By retrospective fourty five SAP patients from May 2002 to January 2008 were enrolled,and 23 patients were chosen for peritoneal lavage by dual lumen catheter, 22 patients received routine treatment only were taken as the control group. The therapeutical effect was compared in two groups. Results After peritoneal lavage,The time for abdominal pain relief and abdominal distention, average days of hospitalization was significantly shorter in the peritoneal lavage group than that in the control group （P 〈 0. 01 ）. The APACHE II scores decrease, hyperamylasemia was shorter in the peritoneal lavage group than that in the control group（P 〈 0. 05 ）. The total incidence of complications including acute renal failure, ARDS, SHOCK, infected, case fatality was lower in the peritoneal lavage group than that in the control group. Conclusion To raise the therapeutical effect, decrease the incidence of complications and mortality in patients with Severe Acute Pancreatitis, Peritoneal Lavage in time was a utility meas.