Clinical Study of Indwelling Catheters in Patients with Severe Acute Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Kun ¹ , SUN Chengyi ¹ , SUN Zaoxi ¹ , WANG Yiping ¹ , ZHANG Leibing ¹ , HUANG Hairong. ²

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Keywords：

Severe acute pancreatitis Indwelling catheter Abdominal drainage Intraabdominal pressure

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【Abstract】ObjectiveTo study the therapeutic effects of indwelling catheters in patients with severe acute pancreatitis (SAP).
MethodsThe clinical data of 113 patients with severe acute pancreatitis admitted to our hospital from Aug. 2002 to May 2004 were collected. The patients were divided into the indwelling catheter group (45 cases) and the control group (68 cases).The APACHEⅡscores and therapeutic results were compared. The drainage and intraabdominal pressure (IPA) were monitored.
Results The APACHEⅡscores on day 2 and day 5 after therapy in indwelling catheter group were significantly decreased compared with the control group(P=0.000).The average hospital stay and cyst morbidity of the indwelling catheter group were significantly decreased compared with those of the control group(P=0.000). The mortality rate was lower in the indwelling catheter group, but there was no statistical difference between these two groups(P gt;0.05). The IAP was positively correlative with the drainage volume, hospital day and APACHEⅡscores(r=0.552, r=0.748, r=0.923，P=0.000).
ConclusionThe indwelling catheter is an important treatment in patients with SAP.

Citation： LI Kun,SUN Chengyi,SUN Zaoxi,WANG Yiping,ZHANG Leibing,HUANG Hairong.. Clinical Study of Indwelling Catheters in Patients with Severe Acute Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(4): 406-408. doi: Copy

1.	Bank S, Singh P, Pooran N, et al. Evaluation of factors that have reduced mortality from acute pancreatitis over the past 20 years [Ｊ]. J Clin Gastroenterol, 2002; 35(1)∶50.
2.	Bosscha K, Hulstaert PF, Hennipman A, et al. Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “planned” reoperations [Ｊ]. J Am Coll Surg, 1998; 187(3)∶255.
3.	汪训实,高友兵,张兆林. 破坏胰腺被膜对重症急性胰腺炎大鼠死亡的影响 [Ｊ]. 美国中华外科学杂志, 2000; 1(1)∶35.
4.	中华医学会外科学分会胰腺学组. 急性胰腺炎的临床诊断及分级标准(1996年第二次方案) [Ｊ]. 中华外科杂志, 1997; 35（12）∶773.
5.	张圣道,雷若庆. 重症急性胰腺炎的诊治方案及发展趋势 [Ｊ]. 中华肝胆外科杂志, 2004; 10(4)∶219.
6.	封光华,蔡阳,贾鹏辉,等. 联合血液滤过和腹膜透析治疗急性重症胰腺炎 [Ｊ]. 中华外科杂志, 2004; 42(5)∶272.
7.	周总光,袁朝新,孙炜,等. 重症急性胰腺炎腹腔镜手术治疗的临床研究 [Ｊ]. 中华外科杂志, 2001; 39(4)∶272.
8.	Cuschieri A. Pancreatic necrosis: pathogenesis and endoscopic management [Ｊ]. Semin Laparosc Surg, 2002; 9(1)∶54.
9.	Appelros S, Lindgren S, Borgstrom A. Short and long term outcome of severe acute pancreatitis [Ｊ]. Eur J Surg, 2001; 167(4)∶281.
10.	Schein M, Wittmann DH, Aprahamian CC, et al. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intraabdominal pressure [Ｊ]. J Am Coll Surg, 1995; 180(6)∶745.
11.	孙家邦,朱斌. 暴发性胰腺炎的诊断及治疗 [Ｊ]. 中国实用外科杂志, 2004; 24(1)∶23.
12.	Gecelter G, Fahoum B, Gardezi S, et al. Abdominal compartment syndrome in severe acute pancreatitis: an indication for a decompressing laparotomy? [Ｊ]. Dig Surg, 2002; 19(5)∶402JP213Iberti TJ, Lieber CE, Benjamin E. Determination of intraabdominal pressure using a transurethral bladder catheter: clinical validation of the technique [Ｊ]. Anesthesiology, 1989; 70(1)∶47.
13.	Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement [Ｊ]. J Am Coll Surg, 1998; 186(5)∶594.
14.	Lacey SR, Bruce J, Brooks SP, et al. The relative merits of various methods of indirect measurement of intraabdominal pressure as a guide to closure of abdominal wall defects [Ｊ]. J Pediatr Surg, 1987; 22(12)∶1207.
15.	JP2Malbrain MLNG. Intraabdominal pressure in the ICU: clinical tool or toy? In: Vincent JL ed. Yearbook of intensive care and emergency medicine [M]. Berlin: SpringerVerlag, 2001∶547-585.

1. Bank S, Singh P, Pooran N, et al. Evaluation of factors that have reduced mortality from acute pancreatitis over the past 20 years [Ｊ]. J Clin Gastroenterol, 2002; 35(1)∶50.
2. Bosscha K, Hulstaert PF, Hennipman A, et al. Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “planned” reoperations [Ｊ]. J Am Coll Surg, 1998; 187(3)∶255.
3. 汪训实,高友兵,张兆林. 破坏胰腺被膜对重症急性胰腺炎大鼠死亡的影响 [Ｊ]. 美国中华外科学杂志, 2000; 1(1)∶35.
4. 中华医学会外科学分会胰腺学组. 急性胰腺炎的临床诊断及分级标准(1996年第二次方案) [Ｊ]. 中华外科杂志, 1997; 35（12）∶773.
5. 张圣道,雷若庆. 重症急性胰腺炎的诊治方案及发展趋势 [Ｊ]. 中华肝胆外科杂志, 2004; 10(4)∶219.
6. 封光华,蔡阳,贾鹏辉,等. 联合血液滤过和腹膜透析治疗急性重症胰腺炎 [Ｊ]. 中华外科杂志, 2004; 42(5)∶272.
7. 周总光,袁朝新,孙炜,等. 重症急性胰腺炎腹腔镜手术治疗的临床研究 [Ｊ]. 中华外科杂志, 2001; 39(4)∶272.
8. Cuschieri A. Pancreatic necrosis: pathogenesis and endoscopic management [Ｊ]. Semin Laparosc Surg, 2002; 9(1)∶54.
9. Appelros S, Lindgren S, Borgstrom A. Short and long term outcome of severe acute pancreatitis [Ｊ]. Eur J Surg, 2001; 167(4)∶281.
10. Schein M, Wittmann DH, Aprahamian CC, et al. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intraabdominal pressure [Ｊ]. J Am Coll Surg, 1995; 180(6)∶745.
11. 孙家邦,朱斌. 暴发性胰腺炎的诊断及治疗 [Ｊ]. 中国实用外科杂志, 2004; 24(1)∶23.
12. Gecelter G, Fahoum B, Gardezi S, et al. Abdominal compartment syndrome in severe acute pancreatitis: an indication for a decompressing laparotomy? [Ｊ]. Dig Surg, 2002; 19(5)∶402JP213Iberti TJ, Lieber CE, Benjamin E. Determination of intraabdominal pressure using a transurethral bladder catheter: clinical validation of the technique [Ｊ]. Anesthesiology, 1989; 70(1)∶47.
13. Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement [Ｊ]. J Am Coll Surg, 1998; 186(5)∶594.
14. Lacey SR, Bruce J, Brooks SP, et al. The relative merits of various methods of indirect measurement of intraabdominal pressure as a guide to closure of abdominal wall defects [Ｊ]. J Pediatr Surg, 1987; 22(12)∶1207.
15. JP2Malbrain MLNG. Intraabdominal pressure in the ICU: clinical tool or toy? In: Vincent JL ed. Yearbook of intensive care and emergency medicine [M]. Berlin: SpringerVerlag, 2001∶547-585.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Study of Indwelling Catheters in Patients with Severe Acute Pancreatitis

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