【作者】 冯刚； 沈惠善； 戚仕均； 谢立江； 方泉； 赵萍； 葛剑洪； 方兴亮；

【Author】 FENG Cang~* FANG Xing-liang Shen Hui-shan. Hepatobiliary Surgery,Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000

【机构】 浙江省绍兴市中医院； 浙江省绍兴市人民医院；

【摘要】 目的探讨重症急性胰腺炎(SAP)患者经腹腔镜置管应用清胰汤行腹腔灌洗治疗的疗效。方法将55例重症急性胰腺炎术后患者分为常规治疗组(27例)和清胰汤组(28例)分别进行治疗,比较两组的疗效和并发症情况。结果常规治疗组治愈5例,有效9例,无效13例,死亡9例,清胰汤组治愈15例,有效8例,无效5例,死亡2例。清胰汤组腹痛腹胀缓解、白细胞正常、淀粉酶正常、CT 改变恢复时间和住院时间均短于常规治疗组(P<0.05)。清胰汤组术后 ARDS、消化道出血、抗菌素相关性肠炎(AAC)、高淀粉酶血症发生率低于常规治疗组(P< 0.05),而胰漏、假性囊肿、休克、急性肾衰和水电解质酸碱失衡两组差异无显著意义。结论重症急性胰腺炎(SAP)患者经腹腔镜置管应用清胰汤行腹腔灌洗治疗能够改善疗效和预后,降低术后并发症发生率和死亡率。更多还原

【Abstract】 Objective To investigate the clinical significance of peritoneal lavage using Qing-Yi-Tang in patients with severe acute pancreatitis (SAP) after laparoscopy operation.Methods Fifty-five SAP patients were divided into routine-treatment group (27 cases) and Qing-Yi-Tang group (28 cases) treated by respective methods Their therapeutic results and complications were analyzed with SPSS14.0.Results Five cases were healed,9 cases effective,13 cases non-effective and 9 cases dead in routine-treatment group,while 15 cases were healed, 8 cases effective,5 cases non-effective and 2 cases dead in Qing-Yi-Tang group.The convalescent time of symptoms/signs,leucocytes count,amylase,etc.and occurrence rate of ARDS,hemorrhage in digestive tract, AAC etc.in Qing-Yi-Tang group were lower than those of routine-treatment group (P<0.05),whereas the differentiation between 2 groups of pancreatic fistula,pseudo cyst,shock,etc.were not obvious significance. Conclusions The use of Qing-Yi-Tang to peritoneal lavage can improve curative effects and prognosis and decrease occurrence rate and mortality in patients with severe acute pancreatitis after laparoscopy operation.更多还原