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目的探讨早期微创腹腔置管灌洗在重症急性胰腺炎(severe acute pancreatitis,SAP)治疗中,对减轻炎性反应的作用。方法选择2007年1月-2009年6月收治的SAP患者56例,随机分为早期微创腹腔置管灌洗组(灌洗组,n=28)和常规治疗组(对照组,n=28);两组同时给予生长抑素,抑酸,抗感染,保持水、电解质及酸碱平衡等综合治疗,灌洗组在常规治疗基础上早期予以微创腹腔置管灌洗。检测两组治疗前及治疗后2、5、7d C反应蛋白(C-reactrve protein,CRP)、血清肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白细胞介素6(interleukin,IL-6)、IL-8水平。结果两组治疗前CRP、TNF-α、IL-6、IL-8水平差异无统计学意义(P>0.05),治疗后2、5、7d比较差异有统计学意义(P<0.05)。结论早期微创腹腔置管灌洗操作简便易行、创伤小、疗效佳,对减轻SAP所致的全身炎性反应具有较好效果,是治疗SAP有效方法之一。
Objective To investigate the effect of early minimally invasive peritoneal lavage in relieving inflammatory reaction in patients with severe acute pancreatitis (SAP). Methods Fifty-six patients with SAP who were admitted from January 2007 to June 2009 were randomly divided into early minimally invasive peritoneal lavage (lavage group, n = 28) and conventional treatment group (n = 28 ). The two groups were treated with somatostatin, acid suppression, anti-infection, water, electrolytes and acid-base balance. The lavage group was treated with minimally invasive peritoneal lavage and early lavage on the basis of routine treatment. The levels of C-reactive protein (CRP), serum tumor necrosis factor α (TNF-α), interleukin (IL-6) ), IL-8 levels. Results There was no significant difference in the levels of CRP, TNF-α, IL-6 and IL-8 between the two groups before treatment (P> 0.05). There was significant difference between the two groups on the 2nd, 5th and 7th day after treatment (P <0.05). Conclusion Early minimally invasive peritoneal lavage and lavage operation is simple and easy to operate, with less trauma and good curative effect. It is one of the effective ways to treat SAP.