Clinical study of early endoscopic therapy for severe acute pancreatitis complicated with intra-abdominal hypertension/abdominal compartment syndrome
10.3969/j.issn.1007-1989.2018.02.013
- VernacularTitle:早期内镜治疗重症急性胰腺炎并发腹腔内高压/腹腔间隔室综合征的效果研究
- Author:
Chuan-Tao SUN
1
;
Sheng-Bao LI
;
Qiang TONG
;
De-Ping LI
;
Fan YANG
;
Wei-Ping DENG
;
Shu JIN
;
Hui-Ming ZHU
Author Information
1. 湖北省十堰市太和医院(湖北医药学院附属医院) 消化内科
- Keywords:
severe acute pancreatitis;
intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS);
peritoneal lavage / peritoneal dialysis;
endoscopic therapy
- From:
China Journal of Endoscopy
2018;24(2):63-67
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of peritoneal lavage and dialysis by flexible endoscope in patients with early phase severe acute pancreatitis (SAP) complicated with intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS). Methods 32 patients with early phase SAP complicated with IAH/ACS were received peritoneal lavage and dialysis by flexible endoscope in base of routine treatment. The release time of peritoneal irritation sign, the duration of intra-abdominal hypertension (IAP), bowel sound, APACHE-II scores and prognosis of the patients were evaluated. The levels of TNF-α and IL-6 in serum, also, the concentrations of TNF-α, IL-6 and amylase in ascites/peritoneal lavage fluid were measured. Results 30 patients were all cured after treatment, with an average hospital stay of (16.53 ± 5.30) d, and, 2 patients underwent surgical treatment. The difference between before and after treatment was significance in peritoneal irritation sign scores, bowel sound, IAP and APACHE-II scores of the patients (P < 0.05). The levels of testing items in serum and ascites/peritoneal lavage fluid were decreased significantly during peritoneal lavage and dialysis. Conclusion Continuous peritoneal lavage and dialysis by flexible endoscope is a safe and effective method for patients with SAP complicated with IAH/ACS, especially in the early stage of disease.
