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目的探讨腹腔镜下置管腹腔灌洗引流术(LPLD)对重症急性胰腺炎(SAP)治疗的临床效果及其预后。方法将37例SAP患者按入院先后顺序随机分为内科组和LPLD组。比较两组治疗前后临床症状缓解时间、相关实验室指标及APACHEⅡ评分;并同时统计两组住院时间、住院费用、治愈率和相关并发症。结果两组SAP患者治疗后,LPLD组体温、腹痛等临床症状缓解速度明显快于内科组;LPLD组白细胞、血淀粉酶及APACHEⅡ评分下降显著;与内科组比较,LPLD组住院费用及住院时间明显缩短,两组治愈率无明显差别;两组的腹腔高压持续时间及腹腔感染和脓肿等并发症的发生率差异有统计学意义。结论 LPLD能有效缓解SAP患者临床症状,缩短住院时间及降低住院费用,减少并发症的发生,但是对于该技术的综合评定尚需观察大宗临床病例。
Objective To investigate the clinical effect and prognosis of laparoscopic peritoneal lavage and drainage (LPLD) on severe acute pancreatitis (SAP). Methods 37 cases of SAP patients were randomly divided into internal medicine group and LPLD group according to the order of hospital admission. The clinical symptom relief time, relevant laboratory indexes and APACHEⅡscores before and after treatment were compared between the two groups. At the same time, the hospitalization time, hospitalization cost, cure rate and related complications were also calculated. Results After treatment, the clinical symptoms of LPLD group such as body temperature and abdominal pain were relieved significantly faster than those of the internal medicine group. The leukocyte, serum amylase and APACHEⅡ scores decreased significantly in LPLD group. Compared with the internal medicine group, the hospitalization cost and hospital stay in LPLD group were significantly higher Shortened, no significant difference between the two groups cure rate; two groups of abdominal pressure duration and abdominal infection and abscess complications such as the difference was statistically significant. Conclusions LPLD can effectively relieve the clinical symptoms, shorten the hospitalization time and reduce the cost of hospitalization in patients with SAP, and reduce the incidence of complications. However, a large number of clinical cases need to be observed for the comprehensive evaluation of this technique.