封闭负压引流在治疗暴发性急性胰腺炎腹腔造口中的应用

Application of vacuum sealing drainage in the treatment of fulminant acute pancreatitis

目的探讨封闭负压引流在暴发性急性胰腺炎腹腔造口中的应用效果。方法分析我院4例暴发性急性胰腺炎患者于腹腔造口后应用封闭负压引流治疗处理的效果。结果4例患者在剖腹探查术后均应用封闭负压引流，使用2周后即在胰腺周围形成清洁腔壁，坏死组织较常规方法清除快，有效避免感染，腹腔早期肿胀消退，胰漏愈合提前，渗出较早停止，创面皮肤肉芽组织新鲜，并能随着冲洗逐渐靠拢。该方法能明显减少换药次数和敷料的使用量，降低医护人员的工作强度。结论对于腹腔造口伴有大量胰周渗液及脏器肿胀的患者，封闭负压引流是控制胰漏、清除坏死组织、保护脏器及创面皮肤的有效方法。

Objective To discuss the clinical effectiveness of vacuum sealing drainage （VSD） used in the treatment of fulminant acute pancreatitis （FAP） after necrosectomy and laparostomy. Methods A retrospective analysis was performed on the clinical data of 4 patients with FAP using VSD after necrosectomy and laparostomy. Results Four patients with FAP received VSD treatment after necrosectomy and laparostomy. VSD effectively washed out necrotic tissue and promoted the formation of clean cavity around the pancreas after 2 weeks postoperatively. This technique has superiority including infection prevention, edema-eliminating, protecting intra-abdominal organs and surgical incision, and promoting healing. This technique can obviously reduce the frequency of dressing change and its amount, and workload of doctors and nurses. Conclusion Using VSD is an effective method to control pancreatic leakage, eliminate necrotic tissue, and protect intra-abdominal organs and surgical incision after necrosectomy and laparostomy for the patients with large amount of effusion and intra-abdominal organ edema.