CONTROLLED CLINICAL-TRIAL OF PERITONEAL-LAVAGE FOR THE TREATMENT OF SEVERE ACUTE-PANCREATITIS
CONTROLLED CLINICAL-TRIAL OF PERITONEAL-LAVAGE FOR THE TREATMENT OF SEVERE ACUTE-PANCREATITIS
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DOI：
10.1056/nejm198502143120703
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发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
IMRIE, CW
中科院分区：
文献类型：
--
作者：
MAYER, AD;MCMAHON, MJ;IMRIE, CW
本文报道了91例重症急性胰腺炎患者行腹腔灌洗（2L/h，连续3d）治疗的多中心、随机、对照临床试验。如果多个实验室标准或诊断性腹腔灌洗提示重度胰腺炎，则患者入组研究。所有患者均接受全面支持治疗。症状发作与随机化之间的中位时间为38小时。患者（46例）被分配到对照组，45例被分配到灌洗组。对照组有13例死亡（28%）和16例严重并发症（35%），而灌洗组有12例死亡（27%）和17例严重并发症（38%）。灌洗似乎没有改变生存期的长度，胰腺收集（假性囊肿或囊肿）的发生率，或血浆淀粉酶浓度。考虑到设计的统计功效，本研究中使用的腹腔灌洗方案对重症胰腺炎的结局影响不大（如果有影响的话）。
A multicenter, randomized, controlled clinical trial of therapeutic peritoneal lavage (2 l/h for 3 days) in 91 patients with severe acute pancreatitis was performed. Patients were entered into the study if severe pancreatitis was indicated by multiple laboratory criteria or diagnostic peritoneal lavage. All patients received full supportive treatment. The median time between the onset of symptoms and randomization was 38 h. Patients (46) were assigned to the control group and 45 to the lavage group. There were 13 deaths (28%) and 16 patients with major complications (35%) in the control group, as compared with 12 deaths (27%) and 17 patients with major complications (38%) in the lavage group. Lavage did not appear to modify the length of survival, the incidence of pancreatic collections (pseudocysts or abscesses), or the plasma amylase concentration. Considering the statistical power of the design, the outcome of severe pancreatitis was not greatly, if at all, influenced by the regimen of peritoneal lavage used in this study.