Efficacy of early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of acute pancreatitis / 中华内分泌外科杂志

ABSTRACT

Objective:To investigate the efficacy of early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of severe acute pancreatitis (SAP) .Methods:170 SAP patients admitted to Quzhou People’s Hospital from Jan. 2016 to Jun. 2020 were divided into the observation group and the control group, with 85 cases in each group, according to the random number table method. The control group received comprehensive medical treatment, while the observation group received early minimally invasive catheterization continuous abdominal lavage and drainage intervention based on the control group. The efficacy and complications after 1 week of treatment were evaluated. Besides, the intra-abdominal pressure (IAP) and acute physiology and chronic health II (APACHEII) were scored, liver and lung function indexes [oxygenation indexes, oxygen partial pressure (PaO 2) , aspartate aminotransferase (AST) , alanine aminotransferase (ALT) ], and inflammation indexes [C-reactive protein (CRP) , tumor necrosis factor-α (TNF-α) , macrophage inflammatory protein-1α (MIP-1α) ] were measured before and 1 week after the treatment. Results:The total effective rate of the treatment in the observation group was 91.77%, which was significantly higher than 77.65% in the control group ( P<0.05) . The level of IAP, APACHEII score, AST, ALT, CRP, TNF-α, MIP-1α of the two groups after 1 week of treatment decreased significantly compared with those before treatment, while the oxygenation index and PaO 2 increased significantly. The levels of IAP, APACHEII score, AST, ALT, CRP, TNF-α, and MIP-1α in the observation group were lower than those in the control group after 1 week of treatment, while the oxygenation index and PaO 2 in the observation group were higher than those in the control group, with statistically significant difference ( P<0.05) . The incidence rates of multiple organ dysfunction syndrome (MODS) , sepsis and systemic inflammatory response syndrome (SIRS) in the observation group were 8.24%, 11.76% and 15.29%, significantly lower than 21.18%, 29.41% and 30.59% in the control group ( P<0.05) . Conclusion:Early minimally invasive catheterization continuous abdominal lavage and drainage in treatment of SAP is safe and effective, which can significantly inhibit pro-inflammatory factors, and protect liver and lung function.