腹腔镜下腹腔灌洗引流治疗重症胰腺炎的疗效  

Efficacy of laparoscopic peritoneal lavage and drainage in the treatment of acute severe pancreatitis

作　　者：李任重[1] 余培[1] 张鹏[1] 

机构地区：[1]湖北省房县人民医院普外科,442100

出　　处：《中华普外科手术学杂志（电子版）》2017年第4期289-291,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜下腹腔灌洗引流(LPLD)治疗重症胰腺炎(SAP)的效果。方法选取2009年1月至2014年12月治疗的80例SAP患者,分为LPLD组38例和常规治疗组42例,常规治疗组给予常规对症治疗,LPLD组在常规治疗组基础上给予LPLD治疗,观察两组治疗效果。统计分析采用SPSS 19.0统计软件,两组间年龄、APACHE-Ⅱ评分、血尿淀粉酶、CRP及住院指标采用(x珋±s)表示,比较使用t检验;并发症比较使用χ~2检验。检验水准=0.05。结果 LPLD组治疗后血淀粉酶、尿淀粉酶和C反应蛋白分别为(79.8±21.2)U/L、(343.0±90.2)U/L和(38.9±14.5)U/L,均明显低于常规治疗组(P<0.05);LPLD组临床症状消失的天数、自主排便时间和住院天数分别为(3.0±1.2)d、(2.1±0.9)d和(11.3±2.4)d,明显短于常规治疗组(P<0.05);LPLD组并发症发生率和病死率分别为7.9%和2.6%,均明显低于常规治疗组(P<0.05)。结论腹腔镜下LPLD治疗SAP有较好的效果,安全可靠,值得临床使用。Objective To investigate the effect of laparoscopic peritoneal lavage and drainage（LPLD） in the treatment of severe acute pancreatitis（SAP）. Methods 80 patients with SAP treated in our hospital from January 2009 to December 2014 were divided into LPLD group（n = 38） and conventional treatment group（n = 42）,the conventional treatmentgroup was given conventional symptomatic treatment,the LPLD group was given LPLD treatment on the basis of the conventional treatment group,the treatment effect of the two groups was observed. SPSS 19. 0 statistical software was used for statistical analysis,The age,APACHE-score,blood amylase,CRP and the index of hospitalization used（x^2± s） representation,were compared by t test,the rate of complications were compared using the χ2test. Results After treatment,the serum amylase,urine amylase and C reactive protein（CRP） in the LPLD group were（79. 8 ±21. 2） U/L,（343. 0 ± 90. 2） U/L and（38. 9 ± 14. 5） U/L,which were significantly lower than those in the conventional treatment group（P 〈0. 05）; The days of LPLD group clinical symptoms disappeared,spontaneous defecation days and the length of hospital stay were（3. 0 ± 1. 2） d,（2. 1 ± 0. 9） d and（11. 3 ± 2. 4） d,which were significantly shorter than those in the conventional treatment group（P〈 0. 05）; The incidence of complications and mortality of the LPLD group were 7. 9% and 2. 6%,which were significantly lower than those in the conventional treatment group（P 〈0. 05）. Conclusion Laparoscopic LPLD treatment of SAP has good effect,is safe and reliable.

关 键 词：胰腺炎 急性坏死性 腹腔镜检查 腹腔灌洗 治疗结果 

分 类 号：R657.51[医药卫生—外科学]