腹腔开放治疗重症急性胰腺炎病人合并腹腔间室综合征的回顾性研究

发布时间：2018-05-06 02:36

本文选题：重症急性胰腺炎 + 腹腔间室综合征　；参考：《肠外与肠内营养》2016年06期

【摘要】：目的:回顾重症急性胰腺炎(SAP)病人合并腹腔间室综合征(ACS)接受腹腔开放术后器官功能的变化及临床结局,分析腹腔开放治疗对病人预后的影响和存在的问题。方法:收集SAP合并ACS并且接受腹腔开放减压的病人10例。记录腹腔开放前后血流动力学参数、器官功能指标和病人的临床结局。结果:本研究共纳入10例病人,平均年龄为(47±13)岁,胆源性胰腺炎为主要患病原因(6/10)。行腹腔开放减压术的具体原因分别为血流动力学紊乱5例,呼吸功能衰竭3例,肾功能衰竭1例,腹腔出血1例。腹腔开放减压后腹腔压力(IAP)明显下降[(30.4±3.062)mm Hg vs(14.5±1.179)mm Hg,P0.05)],但血流动力学和器官功能指标变化趋势各异。10例病人中死亡5例,病死率为50%。结论:腹腔开放减压可明显降低SAP合并ACS病人的IAP,但仍会导致继发性器官功能损害,影响ACS病人的预后。
[Abstract]:Objective: To review the changes of organ function and clinical outcome after open abdominal opening for patients with severe acute pancreatitis (SAP) and abdominal compartment syndrome (ACS), and to analyze the effect of open abdominal treatment on the prognosis of patients and the existing problems. Methods: 10 patients with SAP combined with ACS and open decompression of abdominal cavity were collected and before and after open abdominal opening. Hemodynamic parameters, organ function index and patient's clinical outcome. Results: 10 patients were included in this study, the average age was (47 + 13) years, biliary pancreatitis was the main cause of disease (6/10). The specific reasons for open decompression of abdominal cavity were 5 cases of hemodynamic disorder, 3 cases of respiratory failure, 1 cases of renal failure, and abdominal cavity. 1 cases of hemorrhage, abdominal pressure (IAP) decreased significantly [(30.4 + 3.062) mm Hg vs (14.5 + 1.179) mm Hg, P0.05)], but the change trend of hemodynamics and organ function indexes was 5 in.10 cases, and the fatality rate was 50%. conclusion: open abdominal decompression could obviously reduce SAP with ACS patient's IAP, but still lead to secondary sex The damage of organ function affects the prognosis of ACS patients.

【作者单位】：南京大学医学院附属金陵医院(南京军区南京总医院)解放军普通外科研究所;
【基金】：南京军区卫生部2010年度重点项目
【分类号】：R657.51

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