大承气汤联合血液灌流对重症胰腺炎伴腹腔间隔室综合征的临床疗效

Effect of Dachengqi decoction combined with hemoperfusion on severe acute pancreatitis with abdominal compartment syndrome

目的研究大承气汤联合血液灌流(hemoperfusion,HP)对重症急性胰腺炎(severe acute pancreatitis,SAP)伴腹腔间隔室综合征的临床疗效。方法 30例SAP伴腹腔间隔室综合征的患者随机分为治疗组和对照组,对照组采取常规治疗,治疗组采用常规治疗的基础上给予大承气汤联合血液灌流治疗。在治疗前和治疗后12h、48h,对患者进行C反应蛋白、血清中白细胞介素6(Interleukin-6,IL-6)、白细胞介素8(IL-8)检测,同时进行腹腔内压力监测及APACHEⅡ评分。结果治疗后12h和48h患者的腹腔内压力和C反应蛋白、IL-6,IL-8水平均明显低于治疗前(P<0.05),APACHEⅡ评分降低(P<0.05)。治疗组存活率77.78%(14/18)明显高于对照组41.67%(5/12)(P<0.05)。结论大承气汤联合HP治疗对急性重症胰腺炎伴腹腔间隔室综合征能有效地降低死亡率。

Objective To evaluate the effect of Dachengqi decoction with hemoperfusion on severe acute pancreatitis complicated with abdominal compartment syndrome.Methods 30 patients with SAP were randomly divided into the treatment group（n=18）and the control group（n=12）.The control group were received routine treatment.Based on routine treatment,the treatment group were treated with dachengqi Decoction combined with hemoperfusion.C-reactive protein,IL-6,IL-8 were detected before HP and at 12,48 hours after treatment.At the same time,APACHE II score and intra-abdominal pressure were assessed.Results In the treatment group,the C-reactive protein,IL-6,IL-8,APACHE II score and intra-abdominal pressure were significantly lower than that of the control group at 12 and 48 hours after therapy（P0.05）.The survival rate of the treatment group was significantly higher than that of the control group（77.78% VS 41.67%,P0.05）.Conclusion Dachengqi decoction combined with hemoperfusion could effectively improve the prognosis of patients with SAP with abdominal compartment syndrome.