活性炭应用于暴发性胰腺炎治疗的探讨  

Invstigation of activated charcoal in treatment of fulminant acute pancreatitis

作　　者：石书伟[1] 田新[1] 李俊[1] 华科雷[1] 李瑞霞[1] 

机构地区：[1]焦作市人民医院胰腺外科,河南焦作454150

出　　处：《医药论坛杂志》2013年第5期54-56,共3页Journal of Medical Forum

摘　　要：目的探讨暴发性胰腺炎术后小网膜囊内胰腺周围填充活性炭与棉纱垫对暴发性胰腺炎治疗的效果。方法2002年4月至2010年7月,共收治暴发性胰腺炎25例,其中男17例,女8例,年龄13～74岁,平均40岁,治愈21例,死亡4例,治愈率84%。以2007年4月为界,分为2007年4月以前的14例(棉纱垫组);2007年4月以后的11例(活性炭组)。结果棉纱垫组术后7d内死亡2例,死亡率14.3%(2/14),7d后死亡1例,共死亡3例,总死亡率21.4%(3/14)。活性炭组术后7d内无死亡,7d后死亡1例,总死亡率9%(1/11)。7d内死亡率及总死亡率,棉纱垫组均高于活性炭组。APACHEⅡ评分、T、P及R两组患者术后第3d及第7d均比术后第1d明显好转(P<0.05),但活性炭比纱垫具有更好的优势(P<0.05);棉纱垫组的平均住院天数为(89.91±9.90)d,住院费用为(31.92±3.70)万元;活性炭组平均住院天数(79.00±6.83)d,住院费用(27.38±2.80)万元。两组数据棉纱垫组均高于活性炭组(P<0.05)。结论在暴发性胰腺炎术后小网膜囊灌洗过程中,活性炭在体内炎症介质及毒素的吸附和清除方面,比棉纱垫具有更高的效率,可降低患者术后死亡率。缩短住院时间,减少住院费用。Objective To compared with the effective of gauze pad and activated Charcoal that filled around omental sac and pancreas after FAP （Fulminant acute pancreatitis） with surgery. Methods April 2002 to July 2010,a total of 25 pa- tients with FAP be treated,including 17 males and 8 females, aged 13 -74 years, mean 40 years,21 cases were cured,4 died,the cure rate was 84%. In April 2007 as a dividing line, the previous was 14 cases （Gauze pad group） ,the after was 11 cases （activated Charcoal group）. Results The gauze pad group 2 died within seven days ＇after surgeFy,the mortality rate 14. 3% （2/14） ,1 patient died after seven days,a total of 3 patients died,with a total mortality of 21.4% （3/14）. The activated charcoal group no died within seven days after surgery, 1 patient died after seven days, the total mortality rate of 9% （1/11）. In mortality and total mortality within seven days, Gauze pad group both higher than Activated Charcoal group. The APACHE 11 score,T,P and R on the third and seventh postoperative day was significantly better than the pa- tients on the first day after surgery （P 〈 O. 05 ）, but activated Charcoal was better than Gauze pad group （ P 〈 0. 05 ） ; Gauze pad group,the average hospital stay was （89. 91± 9.90） days,hospitalization costs for （31.92 ± 3.70） thou- sand ; Activated Charcoal group,the average length of stay （79. 00 ± 6. 83 ） days, hospitalization costs for （ 27.38 ±2. 80） thousand. Gauze pad group two sets of data were higher than activated Charcoal group （P 〈 0. 05 ）. Conclusions In the process of lesser sac lavage after FAP,inflammatory mediators and toxins in the body absorption and clearance, the activated Charcoal compared to mat yarn have higher efficiency, it can reduce mortality of patients. Shorter hospital stay and reduce hospital costs.

关 键 词：暴发性胰腺炎 活性炭 灌洗 

分 类 号：R657.5[医药卫生—外科学]