经皮置管引流改善重症急性胰腺炎肠黏膜屏障功能损伤的疗效观察  

Curative Effect of Percutaneous Catheter Drainage in Improvement of Intestinal Mucosal Barrier Injury of Severe Acute Pancreatitis

作　　者：郑晓博[1] 闫洪涛[1] 陈涛[1] 肖乐[1] 唐铭骏[1] 刘鹏[1] 杨林[1] 王科[1] 汤礼军[1] 

机构地区：[1]成都军区总医院全军普通外科中心,成都610083

出　　处：《解放军医药杂志》2014年第7期8-11,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金(81000185);四川省青年科技创新团队基金项目(2011JTD0010)

摘　　要：目的探讨经皮置管引流(PCD)治疗重症急性胰腺炎(SAP)肠黏膜屏障功能损伤的疗效。方法按照随机数字表法将2010年4月—2013年4月收治43例SAP患者随机分为2组:常规保守治疗组21例(对照组),经皮穿刺引流组22例(引流组)。动态观察两组症状和体征的缓解时间、肠道通气恢复时间、腹围及腹腔压力缓解情况、血液检验指标、APACHE-Ⅱ评分、器官衰竭情况。结果引流组腹胀的缓解时间和肠道通气恢复时间较对照组明显缩短(P<0.05);治疗后14 d腹围、腹内压、APACHE-Ⅱ评分、C反应蛋白、器官衰竭发生率及持续时间均较对照组显著降低(P<0.05)。结论 PCD可以促进SAP肠黏膜屏障功能损伤的恢复,以保护肠黏膜屏障功能。Objective To observe the curative effect of percutaneous catheter drainage （PCD） in improvement of intestinal mucosal barrier injury of severe acute pancreatitis （SAP）. Methods A total of 43 patients with SAP during April 2010 and April 2013 were randomly divided into conventional conservative treatment group （control group, n = 21） and PCD group （drainage group, n = 22） according to random number table. Remission time of symptoms and signs, re-covery time of intestinal ventilation, amelioration of abdominal perimeter and abdominal cavity pressure, hematology de-tection indexes, APACHE II score and organ failure status were dynamically observed. Results Compared with those in control group, remission time of abdominal tenderness and recovery time of intestinal ventilation were significantly short-ened （P 〈 0. 05）; values of abdominal perimeter, abdominal cavity pressure, APACHE II scores, C-reactive protein （CRP）, incidence rate and persistence time of organ failure in drainage group were significantly lower and shorter 14 d after treatment （P 〈 0. 05）. Conclusion The method of percutaneous catheter drainage can help recovery of intestinal mucosal barrier injury of severe acute pancreatitis and protect intestinal mucosal barrier function.

关 键 词：胰腺炎 急性坏死性 引流术 治疗效果 

分 类 号：R576.1[医药卫生—消化系统]