腹腔镜下灌洗引流术治疗重症急性胰腺炎的疗效观察

Curative effects of laparoscopic lavage and drainage in the treatment of severe acute pancreatitis

目的探讨腹腔镜下腹腔灌洗引流术(LPLD)治疗重症急性胰腺炎(SAP)的临床疗效。方法回顾性分析本院30例重症胰腺炎患者的临床资料,其中15例患者采用传统开腹手术治疗为对照组,15例采用腹腔镜下灌洗、引流治疗作为观察组,比较效果。结果对照组手术时间为(152.5±28.5)min、住院时间(10.5±4.5)d、术后拔管时间(8.5±4.2)d、术中出血量为(455.1±300.7)mL;观察组手术时间(210.2±48.7)min、住院时间(7.6±2.7)d、术后拔管时间(5.8±2.5)d、术中出血量(336.5±270.2)mL,差异有统计学意义(P<0.05);观察组患者体温恢复时间、肠鸣音恢复时间、器官功能(心、肺、肾)恢复时间均明显短于对照组(P<0.05)。结论 LPLD相比传统开腹手术具有手术创伤小、术后恢复快的优点,同时缩短器官恢复时间,保护器官功能。

Objective To investigate the clinical effect and prognosis of laparoscopic peritoneal lavage and drainage（LPLD） on severe acute pancreatitis（SAP）.Methods Retrospective analyzed of 30 cases of severe pancreatitis patients with the clinical data,including 15 cases with traditional open operation treatment as the control group,15 cases treated by laparoscopic lavage,drainage treatment as the observation group,the effect was compared.Results The operation time was（152.5±28.5）min,hospitalization time was（10.5±4.5）d,postoperative extubation time was（8.5±4.2）d,bleeding during operation was（455.1±300.7）mL in the control group;The operation time was（210.2±48.7）min,hospitalization time was（7.6±2.7）d,postoperative extubation time was（5.8±2.5）d,the amount of intraoperative blood loss（336.5±270.2）mL in the observation group,the difference had statistical significance（P0.05）;The temperature recovery time,borborygmus recovery time of organ function（heart,lung,kidney）recovery time in the observation group was shorter than those in control group（P0.05）.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.