第三型腹膜炎的中西医结合治疗与预后评估  

Tertiary peritonitis treated with integrated traditional Chinese and western medicine and its APACHE Ⅲ scoring

作　　者：夏冬[1] 夏国栋[2] 刘庆[1] 邹庆伟[1] 徐亮[1] 

机构地区：[1]泸州医学院附属医院胃肠外科,646000 [2]泸州医学院附属医院消化内科,646000

出　　处：《实用医学杂志》2014年第7期1164-1167,共4页The Journal of Practical Medicine

基　　金：四川省卫生厅科研项目(编号:090210);泸州市科技局重点科技项目(编号:2009-S-16)

摘　　要：目的:探讨第三型腹膜炎(tertiary peritonitis,TP)的临床治疗方法及其预后评估。方法:78例TP患者随机分组,对比单纯西医治疗和中西医结合治疗的临床疗效,同时利用APACHEⅢ(简称APⅢ)评分系统进行预后评估分析。结果:32例单纯西医治疗组,死亡23例,死亡率为71.9%;46例中西医结合治疗组,死亡15例,死亡率为32.6%(P<0.01)。APⅢ评分与实际病死率间呈显著正相关(r=0.73,P<0.01),APⅢ评分与预计病死率间亦呈显著正相关(r=0.76,P<0.01)。结论:中西医结合治疗TP相较单纯西医治疗有更好的临床疗效,APⅢ评分可用于TP的预后评估。Objective To investigate the clinical features, treatment regimen, and prognosis evaluation of tertiary peritonitis （TP）. Methods Seventy-eight cases with TP were randomly enrolled into 2 groups, including the simple western medicine-treated group （32 cases） and the integrated traditional Chinese and western medicine- treated group （46 cases）. The prognoses were evaluated according to the acute physiology and chronic health evaluation Ⅲ （APACHE Ⅲ, APⅢ） scoring. Results The mortality rate was 71.9% （23 of 32） in patients received the simple western medicine and was 32.6% （15 of 46） in patients received the integrated traditional Chinese and western medicine with significant difference between these two groups （P 〈 0.01 ）. There was a significant correlation between APⅢ score and actual mortality （r = 0.73 ,P 〈 0.01 ）, and predicted mortality （r = 0.76, P 〈 0.01）. Conclusions The therapeutic effect is acceptable and satisfactory for the TP patients received the integrated traditional Chinese and western medicine. The APⅢscoring system can be used to predict the prognosis of rip patients.

关 键 词：腹膜炎 第三型腹膜炎 APACHEⅢ评分 中西医结合治疗 

分 类 号：R656.41[医药卫生—外科学]