Ihse I, Evander A, Gustafson I, Holmberg J T
Ann Surg. 1986 Aug;204(2):122-7. doi: 10.1097/00000658-198608000-00004.
In 39 patients with severe attacks of acute pancreatitis, a longitudinal study was done with respect to the influence of peritoneal lavage on objective prognostic signs (WBC, blood-glucose, serum-calcium, hematocrit, serum-creatinine, arterial pO2, base deficit); amylase activities in peritoneal fluid, serum, and urine; serum-hemoglobin, serum-Na, serum-K, and plasma-insulin. In addition to standard care in the ICU, half of the patients (N = 19) were randomly treated with peritoneal lavage. Peritoneal lavage did not influence overall mortality (13%), incidence of major complications (36%), or hospital stay (23 +/- 7 days). None of the prognostic signs was significantly influenced by lavage. Amylase concentration in peritoneal fluid was significantly reduced in the lavaged group after 6 hours compared to 24 hours in controls. Serum and urinary amylase decreased 12 hours earlier in the lavaged group, indicating an efficiency of the lavage procedure per se. Still, this study did not reveal any beneficial clinical effects of peritoneal lavage in acute pancreatitis.
对39例急性胰腺炎重症发作患者进行了一项纵向研究，内容涉及腹膜灌洗对客观预后指标（白细胞、血糖、血清钙、血细胞比容、血清肌酐、动脉血氧分压、碱缺失）；腹膜液、血清和尿液中的淀粉酶活性；血清血红蛋白、血清钠、血清钾和血浆胰岛素的影响。除了重症监护病房的标准护理外，一半患者（N = 19）被随机给予腹膜灌洗治疗。腹膜灌洗对总死亡率（13%）、主要并发症发生率（36%）或住院时间（23±7天）均无影响。灌洗对任何预后指标均无显著影响。与对照组24小时时相比，灌洗组在6小时后腹膜液中的淀粉酶浓度显著降低。灌洗组血清和尿淀粉酶下降时间比对照组早12小时，表明灌洗操作本身具有一定效果。尽管如此，本研究未揭示腹膜灌洗在急性胰腺炎中有任何有益的临床效果。
