重症急性胰腺炎并发腹腔室隔综合征26例诊治分析  

Diagnosis and treatment of severe acute pancreatitis complicated with abdominal compartment syndromes

作　　者：路文彦[1] 刘三光[1] 刘建华[1] 

机构地区：[1]河北医科大学第二医院肝胆外科,河北石家庄050000

出　　处：《中国现代医学杂志》2010年第12期1863-1865,共3页China Journal of Modern Medicine

摘　　要：目的探讨重症急性胰腺炎(SAP)并发腹腔室隔综合征(ACS)的诊断和治疗方法。方法对该院2001年6月-2008年6月收治的26例SAP并发ACS的临床资料进行回顾性分析。结果该组17例(65.4%)发生在SAP的SIRS期,其中2例行下腹部小切口灌洗引流术,3例行腹腔镜灌洗引流术,11例行开腹减压术,1例行基础治疗加短时血滤。6例(26.1%)发生在SAP感染期(迟发性ACS),其中5例行开腹减压术,1例行腹腔镜灌洗引流术;3例(11.5%)发生在SIRS期和感染期(混合性ACS)。2例早期行小切口腹腔灌洗引流术,后期又开腹减压术,1例行腹腔镜灌洗引流术。该组总死亡率为38.5%(10/26)。结论 ACS是SAP的严重并发症。死亡率极高。早期、及时的诊断与根据不同ACS类型采取的个体化综合治疗是改善ACS预后的关键。【Objective】 To investigate the experience of diagnosis and treatment of abdominal compartment syndrome （ACS） during severe acute pancreatitis （SAP）. 【Methods】 The clinical data of 26 patients with ACS during SAP treated in our hospital from Jun 2001 to Jun 2008 were analyzed retrospectively. 【Results】17 cases （65.4%） of ACS occurred during the SIRS period, in which 2 cases received hypogastric mini-incision lavaged and drainage, 3 cases received laparoscopic peritoneal lavaged and drainage （LPLD）, 11 cases received decompressive celiotomy, and 1 case received basic therapy and short veno-venuous hemofiltration, 6 cases（26.1%） occurred during the period of secondary infection （delayed ACS）, in which 5 cases received decompressive celiotomy and 1 case received LPLD. 3 cases （11.5%） occurred during the both period （mixed ACS）, in which 2 cases received hypogastric mini-incision lavaged in early stage and drainage and decompressive celiotomy in later stage. 1 case received LPLD. The overall mortality is 38.5% （10/26）. 【Conclusion】ACS is a serious complication of SAP with high mortality. Early diagnosis and individualized therapies is vital to improve the prognosis.

关 键 词：重症急性胰腺炎 腹腔室隔综合征 开腹减压术 

分 类 号：R657.5[医药卫生—外科学]