摘要
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±177次／min）、平均动脉压（术前比术后12h，664-18mmHg比79±19mmHg）及体温（术前比术后24h，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48h，（13．84±6．6）×10^9／L比（10．1±5．2）×10^9／L]、C．反应蛋白（术前比术后48h，145±88 mg/L比954±4mg/L）及降钙素原（术前比术后48h，1．44±0．7μg/L比0．9±0．4μg／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。
Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected neerotizing pancreatitis. Methods The clinical data of patients with infected necrotizing panereatitis 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 〈 O. 05 ）. Level of WBC [ preoperative vs. postoperative 48 h, （ 13.8 ±6. 6）× 10^9/L vs. （ 10. 1±5.2） × 10^9/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 p,g/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.
出处
《中华普通外科杂志》
CSCD
北大核心
2015年第1期4-6,共3页
Chinese Journal of General Surgery
关键词
胰腺炎
急性坏死性
清创术
外科手术
微创性
Pancreatitis, acute necrotizing
Debridement
Surgical procedures, minimallyinvasive
