腹腔镜腹腔灌洗引流对重症胰腺炎的临床观察

Effects of Laparoscopic Peritoneal Lavage and Drainage on Severe Acute Pancreatitis

目的探讨腹腔镜下置管腹腔灌洗引流术(LPLD)对重症急性胰腺炎(SAP)治疗的临床效果及其预后。方法将37例SAP患者按入院先后顺序随机分为内科组和LPLD组。比较两组治疗前后临床症状缓解时间、相关实验室指标及APACHEⅡ评分;并同时统计两组住院时间、住院费用、治愈率和相关并发症。结果两组SAP患者治疗后,LPLD组体温、腹痛等临床症状缓解速度明显快于内科组;LPLD组白细胞、血淀粉酶及APACHEⅡ评分下降显著;与内科组比较,LPLD组住院费用及住院时间明显缩短,两组治愈率无明显差别;两组的腹腔高压持续时间及腹腔感染和脓肿等并发症的发生率差异有统计学意义。结论 LPLD能有效缓解SAP患者临床症状,缩短住院时间及降低住院费用,减少并发症的发生,但是对于该技术的综合评定尚需观察大宗临床病例。

Objective To investigate the effect and prognosis of laparoscopic peritoneal lavage and drainage（LPLD） on severe acute pancreatitis（SAP）.Methods Thirty seven patients with SAP were randomly divided into two groups： medicine treatment group and LPLD group.The clinical symptoms,laboratory target and APACHE Ⅱ score were observed before and after the treatment;the days and expenses in hospital,the recovery rate and the clinical prognosis were compared between two groups.Results After the therapy,the clinical symptoms such as temperature and abdominal pain were improved obvious as compared to the medicine treatment group.The serum AMY,WBC and APACHE Ⅱ score in the LDLP group decreased obviously compared to the medicine treatment group.The days and expenses in hospital in the LPLD group reduced significantly,but the cure rate of the two groups had no significantly difference.The duration of intra-abdominal hypertension in the LPLD group reduced significantly,and the rate of abdominal infection and abscess also decreased.Conclusion LPLD can obvious improve the clinical symptoms of SAP,shorten the hospitalization time,reduce the hospitalization expenses and decrease the incidence rate of complications.The comprehensive evaluation for LPLD still needed more observation of clinical cases.