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目的探讨腹腔镜联合动脉区域灌注治疗重症急性胰腺炎(severe acute panereatitis,SAP)的效果。方法将75例 SAP 患者随机分为常规治疗组(35例)和联合治疗组(40例)。常规组进行常规的内科治疗,联合组在常规内科治疗的基础上附加动脉区域灌注及腹腔镜胆囊造瘘和引流。对比两组的有关临床指标和治疗效果。结果联合治疗组慢性健康状况评分Ⅱ评分明显降低(P<0.05),肝、肾功能明显改善(P<0.05),胰腺损害的 CT 评分显著降低(P<0.05),炎性因子、肿瘤坏死因子α及 IL-1β明显减少,IL-10明显增多(P<0.05),器官衰竭发生率明显下降(P<0.05),器官衰竭治疗成功率明显升高(P<0.05),病死率明显降低(P<0.05)。结论在常规治疗基础上附加动脉区域灌注及腹腔镜胆囊造瘘和引流,能有效提高 SAP 的治疗效果,降低病死率。
Objective To investigate the effect of laparoscopic regional perfusion in the treatment of severe acute panereatitis (SAP). Methods 75 SAP patients were randomly divided into routine treatment group (35 cases) and combination therapy group (40 cases). The conventional group received routine medical treatment, and the combined group received arterial regional perfusion and laparoscopic cholecystostomy and drainage on the basis of routine medical treatment. Compare the two groups of clinical indicators and treatment effect. Results The scores of chronic health status score Ⅱ (P <0.05), the function of liver and kidney were significantly improved (P <0.05), and the CT scores of pancreatic lesions were significantly decreased (P <0.05). The levels of inflammatory cytokines, tumor necrosis factor (P <0.05), the incidence of organ failure was significantly decreased (P <0.05), the success rate of organ failure treatment was significantly increased (P <0.05), the mortality was significantly reduced P <0.05). Conclusion In addition to the routine treatment of arterial regional perfusion and laparoscopic cholecystectomy and drainage can effectively improve the therapeutic effect of SAP and reduce mortality.