猪尾巴管腹腔灌洗治疗急性重症胰腺炎介入时机临床研究.docVIP

猪尾巴管腹腔灌洗治疗急性重症胰腺炎介入时机临床研究 　　[摘要] 目的 探讨猪尾巴管腹腔灌洗治疗急性重症胰腺炎介入时机的选择。 方法 采用回顾性队列研究方法，选择2014年3月～2016年10月我院收治60例重症急性胰腺炎患者作为研究对象，在一般保守治疗的基础上，加用猪尾巴管腹腔灌洗治疗，根据介入时机（24h内、48h内、72h内）分为A、B、C组，每组20例；根据B超检查是否可见腹腔积液分为D组和E组；以C反应蛋白（CRP）值、APACHE II值、中性粒细胞计数（NEU）、全身炎症反应综合征（SIRS）持续时间、加用连续肾脏替代疗法（CRRT）例数和死亡例数作为观察指标。 结果 A、B、C组治疗前CRP值、APACHE II值、NEU比较差异无统计学意义（P0.05）；治疗第7天，A、B、C组CRP值、APACHE II值、NEU均较治疗前下降，差异有统计学意义（P0.01），且组间比较差异有统计学意义（P0.05）；随着猪尾巴管腹腔灌洗治疗时间的延迟，CRP??、APACHE II值、NEU下降程度随之减小，差异有统计学意义（P0.05）；A、B、C组无死亡病例，SIRS持续时间、加用CRRT例数比较差异有统计学意义（P0.05）；D组经B超检查可见腹腔积液，共35例；E组经B超检查未见腹腔积液，共25例；D组与E组治疗前腹腔内压比较差异有统计学意义（P0.05）；D?M与E组治疗第7d，腹腔内压均较治疗前下降，差异有统计学意义（P0.01），且组间比较差异有统计学意义（P0.05）。 结论 不同的猪尾巴管腹腔灌洗介入时机在急性重症胰腺炎治疗中的效果不同，若经B超检查可见腹腔积液，在24小时内加用猪尾巴管腹腔灌洗治疗作为最佳的介入时机。 　　[关键词] 急性重症胰腺炎；腹腔灌洗；介入时机 　　[中图分类号] R576 [文献标识码] A [文章编号] 2095-0616（2017）15-154-05 　　[Abstract] Objective To explore the time of interventional therapy for acute severe pancreatitis with peritoneal lavage with pigtail tube. Methods Retrospective cohort study method was used.60 patients with severe acute pancreatitis cured in our hospital grom March 2014 to October 2016 were selected as the study object.On the basis of general conservative treatment，the pig tail tube was used for abdominal lavage.They were divided into group A，group B and group C，according to the timing of intervention（24h，48h，72h），with 20 patients in each group.According to B ultrasonic examination，peritoneal effusion was divided into group D and group E.The C reactive protein（CRP），APACHE，II，neutrophil count（NEU），systemic inflammatory response syndrome（SIRS）duration，and the number of consecutive renal replacement therapy（CRRT）cases and deaths were used as observation indicators. Results There were no statistical significance on CRP value，APACHE，II value，and NEU between the three groups.On the 7d after treatment，the CRP value，APACHE，II value，NEU of group A，group B and group C were lower than before treatment，there were significant differences（P 　　[Key words] Severe acute pan