In situ high-volume modified continuous closed and/or open lavage for infected necrotizing pancreatitis
In situ high-volume modified continuous closed and/or open lavage for infected necrotizing pancreatitis
复制标题
原位大容量改良连续封闭和/或开放灌洗治疗感染性坏死性胰腺炎
DOI：
10.1097/mpa.0b013e31812e9688
复制
发表时间：
2008-01-01
期刊：
影响因子：
2.9
通讯作者：
Wu, Yu Lian
中科院分区：
文献类型：
--
作者：
Dong, Xin;Gao, Shun Liang;Wu, Yu Lian
目的：目的探讨改良大容量持续闭式和（或）开放灌洗治疗感染性坏死性胰腺炎的临床意义。回顾性分析1997年8月至2006年12月在我院接受单腔橡皮管原位大容量（920 L/d）持续封闭灌洗和/或开放灌洗的53例感染性坏死性胰腺炎患者，结果：所有患者均以改良持续闭式灌洗为首选治疗方法，6例继发性腹膜后脓毒症或脓肿患者行持续开放灌洗。这些患者均未发生插管通畅性受损和灌洗液潴留。总死亡率为17.0%（9/53）。早期手术12例，死亡5例（41.7%）;延期手术41例，死亡4例（9.8%）。显著的局部并发症发生在14例（26.4%）;出血，脓肿，瘘的发生率分别为13.2%（7/53），9.4%（5/53），和9.4%（5/53），respectively：我们的原位高容量改良连续封闭和/或开放灌洗技术产生了更好的控制感染坏死性胰腺炎。
Objectives: To evaluate the clinical significance of high-volume modified continuous closed and/or open lavage for the treatment of infected necrotizing pancreatitis.Methods: From August 1997 to December 2006, 53 patients with infected necrotizing pancreatitis who underwent in situ high-volume (920 L/d) continuous closed lavage using a single-lumen rubber catheter and/or open lavage were retrospectively studied in our hospital, and the advantages of this new technique were analyzed.Results: Modified continuous closed lavage was the initial treatment for all patients; in 6 patients with secondary retroperitoneal sepsis or abscess, continuous open lavage was performed. Impaired tube patency and lavage fluid retention did not occur in any of these patients. The overall mortality was 17.0% (9/53). Twelve patients underwent early surgery, and 5 (41.7%) died; 41 patients underwent delayed surgery, and 4 (9.8%) died. Significant local complications occurred in 14 patients (26.4%); the incidence of bleeding, abscess, and fistula was 13.2% (7/53), 9.4% (5/53), and 9.4% (5/53), respectively.Conclusions: Our technique of in situ high-volume modified continuous closed and/or open lavage has produced a better control of infected necrotizing pancreatitis.