暴发性急性胰腺炎时腹腔室膈综合征的处理  

Therapeutic experience of abdominal compartment syndrome in fulminatant acute pancreatitis

作　　者：陈应果[1] 张俊[1] 李起[1] 

机构地区：[1]重庆市重钢总医院普通外科,重庆400081

出　　处：《川北医学院学报》2012年第2期159-161,共3页Journal of North Sichuan Medical College

摘　　要：目的:探讨暴发性急性胰腺炎(fulminant acute pancreatitis,FAP)时腹腔室膈综合征(compartmen syndrome,ACS)的处理对策。方法:回顾性分析我科不同时期收治的FAP 49例,并发ACS 37例。其中A组(2000年1月至2004年6月)16例FAP并发ACS 12例,B组(2004年6月至2010年6月)33例FAP并发ACS 25例,A组早期以传统开腹为主要措施缓解ACS的腹内高压,B组早期以微创手术引流和中药导泻、外敷等综合处理措施缓解ACS的腹内高压。对两组并发ACS的FAP病人的救治情况作统计学分析。结果:FAP并发ACS者居多,本组病例为75.5%。其中,A组腹内高压缓解时间为(4.1±1.7)d、死亡率为43.8%;B组腹内高压缓解时间为2.2±0.9 d、死亡率为21.2%。结论:FAP时ACS发生率高、腹腔室膈综合征是FAP患者病死的主要原因之一。在ICU行监护及最大限度地加强治疗同时早期微创手术引流、中药导泻及外敷等综合处理措施能尽快缓解腹腔高压、改善FAP的预后。Objective：To investigate therapeutic strategies of abdominal compartment syndrome（ACS） in fulminant acute pancreatitis（FAP）.Methods： The clinical data of 49 fulminatant acute pancreatitis patients;37 with abdominal compartment syndrome were admitted to Chongqing General Hospital from January,2000 to June,2010 and reviewed.Theres were divided into two groups;A group of 16 with early open operations（January,2000 to June,2004）,12 with abdominal compartment syndrome amd B group of 33 with early minimally invasive operation and Chinese herbal drug treatment（June,2004 to June,2010） of this group 25 had abdominal compartment syndrome.The clinical characteristic and management of abdominal compartment syndrome in 37 patients with fulminant acute pancreatitis（FAP） were then studied.Results： FAP had a high incidence of abdominal compartment syndrome,The effects of each method were： A group 4.1 ± 1.7 day improvement of abdominal compartment syndrome;nine survived;B group 2.2 ± 0.9 day improvement of abdominal compartment syndrome;26 survived.Conclusion： FAP has high incidence of abdominal compartment syndrome.Supportive measures and chose supervision,early minimally invasive operation,and Chinese herbal drug treatment,improves abdominal compartment syndrome and may be useful to FAP.

关 键 词：暴发性胰腺炎 急性胰腺炎 腹腔间隔室综合征 微创手术 救治 

分 类 号：R576[医药卫生—消化系统]