Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis.
OBJECTIVE
To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine (e.g. Dahuang) in treating abdominal compartment syndrome of fulminant acute pancreatitis.


METHODS
Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group (group 1) and control group (group 2). Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE II scores were applied for analysis.


RESULTS
On the second and fifth days after treatment, APACHE II scores of group 1 and 2 patients were significantly different. Comparison of effectiveness (abdominalgia and burbulence relief time, hospitalization time) between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated (r = 0.552, 0.748, 0.923, P<0.01) with APACHE II scores.


CONCLUSIONS
Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration (SVVH), gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.
Sun
Zhao-Xi
ZX
Department of General Surgery, Affiliated Hospital of Hainan Medical College, Haikou 570102, Hainan Province, China. jialidog@tom.com
Huang
Hai-Rong
HR
Zhou
Hong
H
D000208:Acute Disease; D002404:Catheterization / Q000379:methods; D002408:Catheters, Indwelling; D003161:Compartment Syndromes / Q000150:complications* / Q000628:therapy*; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008516:Medicine, Chinese Traditional; D010195:Pancreatitis / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome