【摘要】 目的 探討早期微創腹腔置管灌洗在重癥急性胰腺炎（severe acute pancreatitis，SAP）治療中，對減輕炎性反應的作用。 方法 選擇2007年1月-2009年6月收治的SAP患者56例，隨機分為早期微創腹腔置管灌洗組（灌洗組，n=28）和常規治療組（對照組，n=28）；兩組同時給予生長抑素，抑酸，抗感染，保持水、電解質及酸堿平衡等綜合治療，灌洗組在常規治療基礎上早期予以微創腹腔置管灌洗。檢測兩組治療前及治療后2、5、7 d C反應蛋白（C-reactrve protein，CRP）、血清腫瘤壞死因子α（tumor necrosis factor α，TNF-α）、 白細胞介素6（interleukin，IL-6）、IL-8水平。 結果 兩組治療前CRP、TNF-α、IL-6、IL-8水平差異無統計學意義（Pgt;0.05），治療后2、5、7 d比較差異有統計學意義（Plt;0.05）。 結論 早期微創腹腔置管灌洗操作簡便易行、創傷小、療效佳，對減輕SAP所致的全身炎性反應具有較好效果，是治療SAP有效方法之一。【Abstract】 Objective To explore the effect of the early minimally invasive peritoneal lavage in severe acute pancreatitis (SAP) from Januany 2007 to June 2009. Methods A total of 56 cases of SAP were randomly divided into early minimally invasive peritoneal lavage group (lavage group, n=28) and conventional treatment group (control group, n=28). The patients were given comprehensive treatment, including somatostatin, acid suppression, anti-infection, and maintaining water, electrolyte, and acid alkali balance.In lavage group, the patients were treated with early minimally invasive peritoneal lavage in addition.The levels of C reactive protein(CRP), serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 8(IL-8)were detected before and 2, 5, 7 days after tretment. Results There was no significant difference in CRP, TNF-α, IL-6, or IL-8 before treament between the two groups (Pgt;0.05). There were significant differences in CRP, TNF-α, IL-6, and IL-8 after treatment between the two groups (Plt;0.05). Conclusion Early minimally invasive peritoneal lavage is a simple, minially invasive, and effective techinique in treating SAP.
