| 清胰汤对急性胰腺炎患者腹腔内压力增高的治疗作用 |
| 投稿时间：2010-03-10 点此下载全文 |
| 引用本文：张立军,于则利,夏峰.清胰汤对急性胰腺炎患者腹腔内压力增高的治疗作用[J].医学研究杂志,2010,39(9):75-78 |
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| 中文摘要:目的评价清胰汤对急性胰腺炎患者腹腔内高压状态的治疗作用；探讨对急性重症患者特别是Ⅱ型病例采取外科手术干预的最佳时机，以减少多脏器衰竭、腹腔内感染等严重并发症，提高重症胰腺炎患者的生存率。方法分析笔者医院自2001年1月~2008年12月期间诊治的216例急性胰腺炎的临床资料，其中重症胰腺炎患者76例（Ⅰ型50例、Ⅱ型26例），全部患者均测定结合应用清胰汤的综合治疗前后的腹腔内压力变化，并与病因、临床资料等分析腹腔内压力的改变与病程进展情况及预后的关系。结果轻型急性胰腺炎患者的腹腔内压力为0 ~10cm水柱，均值3.5±1.8cm水柱；重症患者的腹腔内压力为5~30cm 中，均值16.5±3.8cm水柱；两组有显著性差异。结合清胰汤的综合保守治疗后， 轻型急性胰腺炎患者的腹腔内压力在3~10天内降至正常，平均值3.8±1.5天；重症Ⅰ型患者的腹腔内压力在治疗后7~14天后，47例降至正常，均值6.5±3.8天，3例患者中转手术治疗，2例死亡；在Ⅱ型病例, 7~14天内降至正常者为11例，15例患者仅降至5~18cm水柱, 8例患者进行了手术治疗，死亡4例。3组资料的两两比较有显著性差异。 结论急性胰腺炎患者均可出现腹腔内压力增高，但轻型与重型患者腹腔内压力增高程度及持续时间有显著差异，重症急性胰腺炎的患者合并腹腔内压力增高症的患者预后不佳，腹腔内压力显著而持续的增高可作为评价是否早期手术干预治疗的指标之一。清胰汤对于腹腔内压力的降低有较明显的效果，可能改善SAP的预后。 |
| 中文关键词:急性胰腺炎 急性重症胰腺炎 腹腔内压力 腹腔内高压症 清胰汤 预后 |
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| Effect of Chinese Traditional Medicine Qingyitang on the Intra-abdominal Pressure in Patients with Acute Pancreatitis |
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| Abstract:ObjectiveTo observe the effect of Chinese traditional medicine Qingyitang in reducing the increased intra-abdominal pressure in patients with severe acute pancreatitis(SAP), and analyze the correlation with the intra-abdominal pressure in order to select time for operation for cases with SAP. MethodsFrom Jan 2001 to Dec 2008,216 patients with acute pancreatitis(AP) admitted to our hospital were selected prospectively. According to the value of urinary bladder pressure measurement, we divided the whole patients into three groups (Mild， SAPⅠand SAPⅡ).Intra-abdominal pressure before and after Qingyitang using was monitored by stomach tube or via-rectum based on conservative therapy, respectively.The risk factors and prognosis of intra-abdominal hypertension were analyzed to promote the recognition of abdominal compartment syndrome and treat it timely. ResultsThe level of UBP was significantly high in patients with AP in all groups, and the intra-abdominal pressure score of patients with SAP significantly increased in SAP Ⅱ groups. IAP in all IAH patients was decreased after being treated with Qingyitang. The number of the emergency operation and the complications in IAH group (IAP>20cm) were significantly much more than those of lower IAH group (IAP 11~20cm; IAP 0~11cm). ConclusionIntra-abdominal hypertension has strong correlation with prognosis of SAP, and maybe is one of indictors for surgical approach. The Chinese traditional medicine Qingyitang can decrease the intra-abdominal pressure in cases with AP, and would contributed to reducing significantly morbidity and mortality of surgical treatment for patients with SAP. |
| keywords:Acute pancreatitis Severe acute pancreatitis Intra-abdominal pressure Intra-abdominal hypertension Qingyitang Prognosis |
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