腹腔镜下置管灌洗在重症急性胰腺炎治疗中的临床体会  

The Clinical Experience of Laparoscopic Peritoneal Lavage and Drainage in the Treatment of Severe Acute Pancreatitis

作　　者：谢阗[1] 徐玉冰[1] 林茂珍[1] 

机构地区：[1]广东省揭阳市人民医院普通外科,522000

出　　处：《岭南急诊医学杂志》2011年第2期118-119,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨腹腔镜下置管灌洗在重症急性胰腺炎(SAP)治疗中应用的可行性、临床价值。方法:以2007年1月-2008年12月收治的18例为对照组,2009年1月-2010年12月收治的15例为治疗组,两组均予禁食、胃肠减压、抑酸、抗感染、生长抑素和胃肠外营养支持等综合治疗,治疗组在腹腔镜引导下,彻底腹腔灌洗、引流,术后观察患者腹胀、腹痛程度,监测血清淀粉酶、脂肪酶及尿淀粉酶变化。结果:15例手术均顺利完成,治疗组的死亡率及并发症发生率均明显低于对照组(P<0.05)。结论:腹腔镜下置管灌洗是SAP治疗中一种安全可行的方法,能降低SAP的死亡率和减少并发症。Objective： To explore the feasibility, clinical value of applying laparoscopic peritoneal lavage and drainage to severe acute pancreatitis （SAP）. Methods： The control group included 18 cases from Jan 2007 to Dec 2008 while the treatment group included 15 cases from Jan 2009 to Dec 2010. The treatments given were same, fasting, gastrointestinal decompression, acid suppression, anti-infective, somatostatin and parenteral nutrition support. With the help of laparoscopy, the treatment group received thorough peritoneal lavage and drainage. The eases were observed carefully for abdominal distension and abdominal pain after the operation. The changes of serum amylase, lipase and urine amylase were monitored closely. Results：The treatment group operated successfully. Mortality and complication rates were lower significantly in the treatment group than that in the control group（P〈0.05）. Conclusion： Laparoscopic peritoneal lavage and drainage is a safe and feasible method in treating SAP, decreases mortality and reduce complications of SAP.

关 键 词：重症急性胰腺炎 腹腔镜 灌洗 

分 类 号：R657.51[医药卫生—外科学]