早期通便、引流治疗重症急性胰腺炎腹腔高压的效果观察
目的：探讨早期通便、引流对重症急性胰腺炎（SAP）治疗的效果。方法回顾性分析株洲市中心医院肝胆胰外科2009年1月－2015年1月收治的52例 SAP 患者的临床资料，分为常规治疗组（22例）和通便引流组（30例）。比较两组2周内多器官功能不全综合征及腹腔间隔室综合征发生率、腹内压降至15 cm H2 O 以下时间、胃肠功能恢复时间、胰腺感染率和病死率的差异。两组间计量资料比较采用独立样本 t 检验；计数资料比较采用χ2检验。结果与常规治疗组相比，早期通便引流组患者2周内多器官功能不全综合征及腹腔间隔室综合征发生率显著降低（31．8％ vs 10．0％，22．7％ vs 3．3％，χ2值分别为...
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| Published in | 临床肝胆病杂志 Vol. 33; no. 1; pp. 106 - 109 |
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| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
株洲市中心医院 肝胆胰外科,湖南 株洲,412000
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 |
| DOI | 10.3969/j.issn.1001-5256.2017.01.023 |
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| Summary: | 目的：探讨早期通便、引流对重症急性胰腺炎（SAP）治疗的效果。方法回顾性分析株洲市中心医院肝胆胰外科2009年1月－2015年1月收治的52例 SAP 患者的临床资料，分为常规治疗组（22例）和通便引流组（30例）。比较两组2周内多器官功能不全综合征及腹腔间隔室综合征发生率、腹内压降至15 cm H2 O 以下时间、胃肠功能恢复时间、胰腺感染率和病死率的差异。两组间计量资料比较采用独立样本 t 检验；计数资料比较采用χ2检验。结果与常规治疗组相比，早期通便引流组患者2周内多器官功能不全综合征及腹腔间隔室综合征发生率显著降低（31．8％ vs 10．0％，22．7％ vs 3．3％，χ2值分别为3．89、4．68，P 值分别为0．049、0．031），胰腺感染率及病死率显著下降（40．9％ vs 13．3％，22．7％ vs 3．3％，χ2值分别为5．15、4．68，P 值分别为0．023、0．031）。与常规治疗组相比，早期通便引流组患者腹内压降至15 cm H2 O 以下时间[（4．7±1．0）d vs （8．3±0．9）d]、肠鸣音[（3．0±0．5）d vs （6．5±0．9）d]及排气排便恢复时间[（3．8±0．7）d vs （7．8±0．9）d]明显缩短，差异均有统计学意义（t 值分别为1．02、6．67、2．13，P 值均＜0．01）。结论 SAP 早期采取通便、引流可有效降低腹腔高压的程度，保护重要脏器功能，一定程度缓解 SAP 的病情，减少并发症的出现，从而显著改善 SAP 的预后。 |
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| Bibliography: | Objective To investigate the clinical effect of early bowel -relaxing treatment and drainage in the treatment of severe acute pan-creatitis （SAP）.Methods A retrospective analysis was performed for the clinical data of 52 patients with SAP who were admitted to De-partment of Hepatopancreatobiliary Surgery,Zhuzhou Central Hospital,from January 2009 to January 2015,and these patients were divided into conventional treatment group with 22 patients and early bowel -relaxing/drainage group with 30 patients.The incidence of multiple or-gan dysfunction syndrome and abdominal compartment syndrome within 2 weeks,time to intra -abdominal pressure reduced to below 15 cm H2 O,time to gastrointestinal function recovery,pancreatic infection rate,and mortality rate were compared between the two groups.The in-dependent samples t -test was used for comparison of continuous data between the two groups,and the chi -square test was used for compar-ison of categorical data.Results Compared with the conventional treatment group,the |
| ISSN: | 1001-5256 |
| DOI: | 10.3969/j.issn.1001-5256.2017.01.023 |