重症急性胰腺炎合并腹腔间隙综合征的诊断和治疗

目的探讨重症急性胰腺炎（severe acute pancreatitis，SAP）合并腹腔间隙综合征（abdominal compartment syndrome，ACS）的诊断和治疗方法。方法总结我院1999年6月至2004年6月收治的12例重症急性胰腺炎合并腹腔间隙综合征的临床资料，分析其诊断及治疗方法。结果本组12例患者均经积极的针对SAP的药物治疗，其中10例经穿刺或开腹引流进行腹腔减压。本组12例中治愈9例，好转后出院1例，死亡2例。结论对重症急性胰腺炎患者常规进行腹内压监测，不但可及时诊断腹腔间隙综合征，而且可协助判断重症急性胰腺炎的手术时机。本病的治疗方法主要是以腹腔减压为主的综合治疗。

Diagnosis and treatment of the severe acute pancreatitis associated with abdominal compartment syndrome

Objective To investigate the diagnosis and treatment of the severe acute pancre-atitis(SAP) associacted with abdominal compartment syndrome(ACS). Methods From June 1999 to June 2004, 12 cases with severe acute pancreatitis associacted with abdominal compartment syndrome were analyzed retrospectively. Results All cases were treated actively with medicine, and 10 cases underwent peritoneal decompression through Puncture(peritoneocentesis) or laparotomy drainage. Among them, 9 cases were cured, 1 case was improved and 2 cases died. Conclusion Monitoring of intra-abdominal pressure for SAP can not only as early as possible to diagnose ACS, but also can assist to judge the operative timing of SAP. Peritoneal decompression plus complex treatment are a main therapeutic method for the treatment of the SAP associated with ACS.