中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
10期
1096-1099
,共4页
李俊英%董芸%章晓红%陈友岱%郑君%苏明华
李俊英%董蕓%章曉紅%陳友岱%鄭君%囌明華
리준영%동예%장효홍%진우대%정군%소명화
中心静脉导管%重症急性胰腺炎%腹腔积液%引流%腹内压%乳酸%降钙素原%多器官功能不全
中心靜脈導管%重癥急性胰腺炎%腹腔積液%引流%腹內壓%乳痠%降鈣素原%多器官功能不全
중심정맥도관%중증급성이선염%복강적액%인류%복내압%유산%강개소원%다기관공능불전
Central venous catheter%Severe acut pancreatitis%Seroperitoneum%Drainage%Intra-abdominal pressure%Lactic acid%Procalcitonin%Multiple organ disfunction syndrome
目的 探讨中心静脉置管持续腹腔引流在重症急性胰腺炎(SAP)的临床应用.方法 将62例重症急性胰腺炎且有腹腔积液的患者,采用随机(随机数字法)分为中心静脉置管腹腔引流组(观察组,31例)和常规治疗组(对照组,31例).两组均给予相同内科治疗,观察组给予中心静脉导管腹腔置管持续引流.检测两组患者引流前及引流后第12 h、24 h、48 h、72 h腹腔压力(IAP),乳酸(LAC),降钙素原(PCT),并观察患者腹痛、腹胀及肠道功能恢复时间及多器官功能不全(MODS)发生率.结果 对照组患者均一次穿刺引流成功,观察组腹腔压力、乳酸、降钙素原较对照组均不同程度降低；腹痛、腹胀症状缓解,肠道功能恢复时间缩短；MODS发生率明显低于对照组.结论 中心静脉腹腔置管持续引流治疗重症急性胰腺炎,是一种安全有效的引流方式,值得临床广泛应用.
目的 探討中心靜脈置管持續腹腔引流在重癥急性胰腺炎(SAP)的臨床應用.方法 將62例重癥急性胰腺炎且有腹腔積液的患者,採用隨機(隨機數字法)分為中心靜脈置管腹腔引流組(觀察組,31例)和常規治療組(對照組,31例).兩組均給予相同內科治療,觀察組給予中心靜脈導管腹腔置管持續引流.檢測兩組患者引流前及引流後第12 h、24 h、48 h、72 h腹腔壓力(IAP),乳痠(LAC),降鈣素原(PCT),併觀察患者腹痛、腹脹及腸道功能恢複時間及多器官功能不全(MODS)髮生率.結果 對照組患者均一次穿刺引流成功,觀察組腹腔壓力、乳痠、降鈣素原較對照組均不同程度降低；腹痛、腹脹癥狀緩解,腸道功能恢複時間縮短；MODS髮生率明顯低于對照組.結論 中心靜脈腹腔置管持續引流治療重癥急性胰腺炎,是一種安全有效的引流方式,值得臨床廣汎應用.
목적 탐토중심정맥치관지속복강인류재중증급성이선염(SAP)적림상응용.방법 장62례중증급성이선염차유복강적액적환자,채용수궤(수궤수자법)분위중심정맥치관복강인류조(관찰조,31례)화상규치료조(대조조,31례).량조균급여상동내과치료,관찰조급여중심정맥도관복강치관지속인류.검측량조환자인류전급인류후제12 h、24 h、48 h、72 h복강압력(IAP),유산(LAC),강개소원(PCT),병관찰환자복통、복창급장도공능회복시간급다기관공능불전(MODS)발생솔.결과 대조조환자균일차천자인류성공,관찰조복강압력、유산、강개소원교대조조균불동정도강저；복통、복창증상완해,장도공능회복시간축단；MODS발생솔명현저우대조조.결론 중심정맥복강치관지속인류치료중증급성이선염,시일충안전유효적인류방식,치득림상엄범응용.
Objective To investigate the application of the central venous catheter (CVC) specialized for drainage intervention in severe acute pancreatitis (SAP) patients.Methods Sixty-two severe acute pancreatitis patients with seroperitoneum were randomly (random number) assigned into two groups:the drainage group (n =31) and the control group (n =31).All patients were treated with conventional internal medicine therapy.Patients of drainage group were treated with continuous peritoneal drainage by using the central venous catheter.The intra-abdominal pressure (IAP),lactic acid (LAC),and procalcitonin (PCT) were detected before and 12 h,24 h,48 h,72 h,5 days after intraperitoneal drainage.The symptoms of abdomen pain,abdomen distention,resume of bowel movement and the rate of MODS were observed.Results All patients with drainage got catheter successfully inserted.Compared with the control group,the IAP,LAC and PCT decreased significantly in the patients of drainage group.And the duration of abdomen pain,abdomen distention and resume of bowel movement function in the drainage group were shorter and the rate of MODS was lower.Conclusions Application of CVC specialized for intraperitoneal drainage is a safe and effective method for the treatment of pancreatitis with seroperitoneum.It is worthwhile to be widely used in clinic.
