中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
1期
4-6
,共3页
曹锋%李嘉%李昂%方育%李非
曹鋒%李嘉%李昂%方育%李非
조봉%리가%리앙%방육%리비
胰腺炎,急性坏死性%清创术%外科手术,微创性
胰腺炎,急性壞死性%清創術%外科手術,微創性
이선염,급성배사성%청창술%외과수술,미창성
Pancreatitis,acute necrotizing%Debridement%Surgical procedures,minimally invasive
目的 探讨视频辅助腹膜后清创(video-assisted retroperitoneal debridement,VARD)在重症急性胰腺炎继发感染患者炎症控制中的作用.方法 回顾性分析首都医科大学宣武医院32例次VARD患者的临床资料,采用配对样本t检验比较治疗前后患者心率、平均动脉压、体温及炎症反应指标(白细胞、C-反应蛋白及降钙素原)的变化.结果 经VARD治疗,患者心率(术前比术后8h,108±22次/min比95±17次/min)、平均动脉压(术前比术后12 h,66±18 mmHg比79±19 mmHg)及体温(术前比术后24 h,38.3±1.7℃比37.3 ±1.3℃)状况较前均有好转(均P＜0.05),血白细胞计数[术前比术后48 h,(13.8 ±6.6)×109/L比(10.1±5.2)×109/L]、C-反应蛋白(术前比术后48 h,145±88 mg/L比95±4 mg/L)及降钙素原(术前比术后48 h,1.4 ±0.7 μg/L比0.9±0.4 μg/L)亦明显下降,差异均有统计学意义(均P＜0.05).结论 VARD治疗能显著减轻重症急性胰腺炎继发感染患者的全身炎症反应,改善患者一般状况.
目的 探討視頻輔助腹膜後清創(video-assisted retroperitoneal debridement,VARD)在重癥急性胰腺炎繼髮感染患者炎癥控製中的作用.方法 迴顧性分析首都醫科大學宣武醫院32例次VARD患者的臨床資料,採用配對樣本t檢驗比較治療前後患者心率、平均動脈壓、體溫及炎癥反應指標(白細胞、C-反應蛋白及降鈣素原)的變化.結果 經VARD治療,患者心率(術前比術後8h,108±22次/min比95±17次/min)、平均動脈壓(術前比術後12 h,66±18 mmHg比79±19 mmHg)及體溫(術前比術後24 h,38.3±1.7℃比37.3 ±1.3℃)狀況較前均有好轉(均P＜0.05),血白細胞計數[術前比術後48 h,(13.8 ±6.6)×109/L比(10.1±5.2)×109/L]、C-反應蛋白(術前比術後48 h,145±88 mg/L比95±4 mg/L)及降鈣素原(術前比術後48 h,1.4 ±0.7 μg/L比0.9±0.4 μg/L)亦明顯下降,差異均有統計學意義(均P＜0.05).結論 VARD治療能顯著減輕重癥急性胰腺炎繼髮感染患者的全身炎癥反應,改善患者一般狀況.
목적 탐토시빈보조복막후청창(video-assisted retroperitoneal debridement,VARD)재중증급성이선염계발감염환자염증공제중적작용.방법 회고성분석수도의과대학선무의원32례차VARD환자적림상자료,채용배대양본t검험비교치료전후환자심솔、평균동맥압、체온급염증반응지표(백세포、C-반응단백급강개소원)적변화.결과 경VARD치료,환자심솔(술전비술후8h,108±22차/min비95±17차/min)、평균동맥압(술전비술후12 h,66±18 mmHg비79±19 mmHg)급체온(술전비술후24 h,38.3±1.7℃비37.3 ±1.3℃)상황교전균유호전(균P＜0.05),혈백세포계수[술전비술후48 h,(13.8 ±6.6)×109/L비(10.1±5.2)×109/L]、C-반응단백(술전비술후48 h,145±88 mg/L비95±4 mg/L)급강개소원(술전비술후48 h,1.4 ±0.7 μg/L비0.9±0.4 μg/L)역명현하강,차이균유통계학의의(균P＜0.05).결론 VARD치료능현저감경중증급성이선염계발감염환자적전신염증반응,개선환자일반상황.
Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.
