腹腔镜下腹腔灌洗术对重症急性胰腺炎的疗效分析  

Curative effects of peritoneal lavage under laparoscope on severe acute pancreatitis patients

作　　者：李宛霞[1] 陶少宇[1] 李玲辉[2] 熊立红[1] 李国平[1] 

机构地区：[1]南昌大学第二附属医院ICU,330006 [2]南昌大学医学院门诊部消化内科,330006

出　　处：《中国急救医学》2009年第1期24-26,共3页Chinese Journal of Critical Care Medicine

基　　金：江西省卫生厅课题资助项目（No.20053087）

摘　　要：目的探讨腹腔镜下腹腔灌洗术对重症急性胰腺炎（SAP）治疗的疗效。方法将60例SAP患者按入院先后顺序随机分为腹腔灌洗组和传统治疗组，每组30例。观察两组治疗前后血清TNF-α和IL-8水平的变化，比较两组腹内高压持续时间、住院时间、腹腔感染和血性感染的发生率及死亡率。结果两组患者治疗后血清TNF-α和IL-8水平均显著下降，且腹腔灌洗组较传统治疗组下降更为明显。腹腔灌洗组腹内高压持续时间和住院时间明显缩短，腹腔感染显著减少，血性感染和死亡率也有所下降。结论腹腔镜下腹腔灌洗术能够降低SAP患者炎症介质，缓解腹内高压，减少腹腔感染，缩短住院时间，对预后有益。Objective To investigate the effect of peritoneal lavage under laparoscope on the patients with severe acute pancreatitis. Methods 60 patients with severe acute pancreatitis were randomly divided into two groups： 30 patients received peritoneal lavage, the others received routine treatment as the control group. The change of serum TNF - α and IL - 8 level of the two groups were observed before and after the therapy. The duration of intra - abdominal hypertension, days in hospital, the rate of peritoneal infection and hematogenous infection and mortality were compared between two groups. Results After the therapy, serum TNF - α level and IL - 8 level of the two groups decreased more markedly than those before therapy. The level in the peritoneal lavage group was lower than that in the control group. Compared with the control group, the duration of intra -abdominal hypertension, days in hospital and the rate of peritoneal infection in the peritoneal lavagc group reduced significantly, and the rate of hematogenous infection and mortality also decreased. Conclusion Peritoneal lavage under laparoscope can decrease the inflammatory response, lessen intra - abdominal hypertension, reduce the chance of peritoneal infection, shorten days in hospital and improve the prognosis of patients with severe acute pancreatitis.

关 键 词：腹腔灌洗 腹腔镜 重症急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]