CAJ | 학술논문

目的本文拟对SAP患者经膀胱间接监测IAH和早期应用腹腔镜技术治疗SAP和IAH重要性进行探讨.方法对我院12年来收治的201例SAP患者,进行了常规IAP测定,IAP＞ 25 mmHg60例.按单双号将患者分为两组,A组30例进行腹腔镜下灌洗、引流、清除坏死组织手术,B组30例给予禁食、胃肠减压、抗感染、生长抑素等综合治疗待腹腔脓肿形成后再进行剖腹手术.结果两组病死率分别为16.7％、23.3％.并发AODS率为10.0％、20.0％.A组腹内高压持续时间和住院时间较B组明显缩短(P＜0.05),腹腔感染发生率明显降低(P＜0.05),血性感染发生率和死亡率也有所减少(P＜0.05).结论 SAP诊断成立IAP升高＞25 mmHg以上,应尽早在腹腔镜下经腹膜外径路进行腹腔灌洗、引流、清除坏死组织.
목적 본문의대SAP환자경방광간접감측IAH화조기응용복강경기술치료SAP화IAH중요성진행탐토.방법 대아원12년래수치적201례SAP환자,진행료상규IAP측정,IAP＞ 25 mmHg60례.안단쌍호장환자분위량조,A조30례진행복강경하관세、인류、청제배사조직수술,B조30례급여금식、위장감압、항감염、생장억소등종합치료대복강농종형성후재진행부복수술.결과 량조병사솔분별위16.7％、23.3％.병발AODS솔위10.0％、20.0％.A조복내고압지속시간화주원시간교B조명현축단(P＜0.05),복강감염발생솔명현강저(P＜0.05),혈성감염발생솔화사망솔야유소감소(P＜0.05).결론 SAP진단성립IAP승고＞25 mmHg이상,응진조재복강경하경복막외경로진행복강관세、인류、청제배사조직.
Objective To explore the importance of monitoring intra-abdominal hypertension (IAH)through bladder and early application of laparoscopic techniques for the patients with severe acute pancreatitis (SAP).Methods Data of intra-abdominal pressure (IAP) from 201 SAP patients hospitalized in the past 12 years was observed and 60 cases (IAP＞25 mmHg)were included.According to the order of admission,patients were randomly divided into singular group (observation) and dual groups (control) (n=30).Group A was treated by laparoscopic irrigation,drainage and removing necrotic tissue,while the group B was given traditional comprehensive treatment including dual fast,gastrointestinal decompression,resistance to infection,somatostatin and laparotomy in case of abdominal abscess formation.Results Case fatality rate in the two groups were 16.7％ and 23.3％ respectively and concurrent arterial occlusive diseases (AODs) rate were 10.0％ and 20.0％.For the complications and prognosis,IAH duration and hospitalization time in group A were significantly shortened (P＜0.05)while abdominal cavity infection rate was decreased obviously (P＜0.05) compared with those of group B.Hemorrhagic infection incidence and mortality rate in group A were also reduced (P＜0.05).Conclusion Once SAP diagnosis established (IAP＞25mmHg),early treatment by laparoscopic irrigation,drainage and removing necrotic tissue via peritoneal outside diameter should be conducted.