重症急性胰腺炎59例治疗体会

J4 ›› 2011, Vol. 10 ›› Issue (2): 35-37.

重症急性胰腺炎59例治疗体会

大理学院附属医院，云南大理 671000

收稿日期:2010-12-27 出版日期:2011-02-15 发布日期:2011-02-15
作者简介:邹天雷，副主任医师，主要从事重症监护研究.

Therapeutic Experience in 59 Patients of Severe Acute Pancreatitis

Affiliated Hospital of Dali University, Dali, Yunnan 671000, China

Received:2010-12-27 Online:2011-02-15 Published:2011-02-15

摘要/Abstract

摘要：

目的：探讨血液净化、腹腔灌洗引流术加早期呼吸机支持治疗重症急性胰腺炎合并多器官功能衰竭的效果。方法：对59
例重症急性胰腺炎合并多器官功能衰竭，尤其合并腹腔间隔室综合征患者在常规治疗基础上行床旁血液净化、腹腔灌洗引流术加早期呼吸机支持治疗等，监测治疗前后生命体征及血生化指标。结果：59例患者中45例存活，存活率76.27%；45例患者在治疗过程中血流动力学状态稳定，平均动脉压、心率和氧合指数均有所改善，差异有统计学意义（P＜0.05）；治疗前后血淀粉酶、脂肪酶、血乳酸、C-反应蛋白、血尿素氮（BUN）、血肌酐（Scr）和急性生理及慢性健康状况评分Ⅱ（APACHEⅡ）较治疗前明显下降，差异有统计学意义（P＜0.05）。结论：血液净化、腹腔灌洗引流术加早期呼吸机支持，对维护重症急性胰腺炎合并多器官功能衰竭具有重要意义。

关键词: 重症胰腺炎, 血液净化, 腹腔灌洗引流术, 呼吸机支持

Abstract:

Objective: To investigate the treatment of severe acute pancreatitis （SAP）with multiple organ failure （MOF）by using blood purification, peritoneal lavage and drainage and ventilator support. Methods: Fifty-nine cases of SAP with MOF, especially patients with abdominal compartment syndrome, were treated with continuous blood purification, peritoneal lavage and drainage, and ventilator support. And their vital signs and blood biochemistry before and after treatment were detected. Results: Forty-five cases survived after treatment, survival rate was 76.27%. Data have shown there were more stable hemodynamics, improved mean arterial pressure, heart rate and oxygenation index in 45 survival cases group （P<0.05）. Hemodiastase, lipidase and lactic acid in blood, Creactive protein, blood urea nitrogen, serum creatinine and APACHEⅡ index were obviously reduced after treatment （P<0.05）.Conclusion: Blood purification, peritoneal lavage and drainage, and ventilator support were with great clinical significance in treating SAP with MOF.

Key words: severe acute pancreatitis, blood purification, peritoneal lavage and drainage, ventilator support

中图分类号:

R576

邹天雷, 赵永茂, 杨建飞. 重症急性胰腺炎59例治疗体会[J]. J4, 2011, 10(2): 35-37.

ZOU Tian-Lei, ZHAO Yong-Mao, YANG Jian-Fei. Therapeutic Experience in 59 Patients of Severe Acute Pancreatitis[J]. J4, 2011, 10(2): 35-37.