重症急性胰腺炎与腹腔室隔综合征的研究进展_West China Medical Journal

Authors：

万美华 , 唐文富 , 夏庆

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Keywords：

重症急性胰腺炎; 腹腔室隔综合征; 腹内高压

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【摘要】　在重症急性胰腺炎（severe acute pancreatitis，SAP）发生时，能及时认识并诊断腹内高压（intra abdominal hypertension，IAH）甚至腹腔室隔综合征（abdominal compartment syndrome，ACS），并给予及时的治疗有可能逆转其带来的进一步的病理生理损害。因此，认识并了解IAH和ACS的发病机制、特征、诊断与治疗进展在SAP的治疗中有重要意义，现就上述方面进行综述。

Citation： 万美华,唐文富,夏庆. 重症急性胰腺炎与腹腔室隔综合征的研究进展. West China Medical Journal, 2011, 26(9): 1420-1423. doi: Copy

1.	De Waele JJ, De Laet I, Kirkpatrick AW, et al. Intra-abdominal hypertension and abdominal compartment syndrome [J]. Am J Kidney Dis, 2011, 57(1): 159-169.
2.	De Waele JJ, Hesse UJ. Life saving abdominal decompression in a patient with severe acute pancreatitis [J]. Acta Chir Belg, 2005, 105 (1): 96-98.
3.	Sugrue M, Jones F, Deane SA, et al. Intra-abdominal hypertension is an independent cause of postoperative renal impairment [J]. Arch Surg, 1999, 134(10): 1082-1085.
4.	Al-Bahrani AZ, Darwish A, Hamza N, et al. Gut barrier dysfunction in critically ill surgical patients with abdominal compartment syndrome [J]. Pancreas, 2010, 39(7): 1064-1069.
5.	De Waele JJ, Hoste E, Blot SI, et al. Intra-abdominal hypertension in patients with severe acute pancreatitis [J]. Crit Care, 2005, 9(4): 452-457.
6.	Sanchez NC, Tenofsky PL, Dort JM, et al. What is normal intra-abdominal pressure? [J]. Am Surg, 2001, 67(3): 243-248.
7.	Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration [J]. Ann Surg, 1983, 199(1): 28-33.
8.	World Society of Abdominal Compartment Syndrome Consensus Conference Definitions. In: Inaugural World Congress-Abdominal Compartment Syndrome. 2004.
9.	Malbrain ML, De laet I, Cheatham M. Consensus conference definitions and recommendations on intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) - the long road to the final publications, how did we get there? [J]. Acta Clin Belg, 2007(Suppl 1): 44-59.
10.	Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions [J]. Intensive Care Med, 2006, 32: 1722-1732.
11.	Dambrauskas Z, Parseliunas A, Gulbinas A, et al. Early recognition of abdominal compartment syndrome in patients with acute pancreatitis [J]. World J Gastroenterol, 2009, 15(6):717-721.
12.	Marx G, Vangerow B, Burczyk C, et al. Evaluation of noninvasive determinants for capillary leakage syndrome in septic shock patients[J]. Intensive Care Med, 2000, 26 (9): 1252-1258.
13.	Rezende-Neto JB, Moore EE, Melo de Andrade MV, et al. Systemic inflammatory response secondary to abdominal compartment syndrome: stage for multiple organ failure [J]. J Trauma, 2002, 53(6): 1121-1128.
14.	De Waele JJ, Hesse UJ. Life saving abdominal decompression in a patient with severe acute pancreatitis [J]. Acta Chir Belg, 2005, 105(1): 96-98.
15.	Mao EQ, Tang YQ, Fei J, et al. Fluid therapy for severe acute pancreatitis in acute response stage [J]. Chin Med J (Engl), 2009, 122(2): 169-173.
16.	Zhang WF, Ni YL, Cai L, et al. Intraabdominal pressure monitoring in predicting outcome of patients with severe acute pancreatitis[J]. Hepatobiliary Pancreat Dis Int, 2007, 6(4): 420-423.
17.	Chang MC, Miller PR, D’Agostino R Jr, et al. Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension [J]. J Trauma, 1998, 44(3): 440-445.
18.	Obeid F, Saba A, Fath J, et al. Increases in intra-abdominal pressure affect pulmonary compliance [J]. Arch Surg, 1995, 130(5): 544-548.
19.	Sugerman HJ, Bloomfield GL, Saggi BW. Multisystem organ failure secondary to increased intraabdominal pressure [J]. Infection, 1999, 27(1): 61-66.
20.	Diebel LN, Dulchavsky SA, Wilson RF. Effect of increased intra-abdominal pressure on msenteric arterial and intestinal mucosal blood-flow [J]. J Trauma, 1992, 33(1): 45-49.
21.	Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low-flow states [J]. Arch Surg, 1970, 101(4): 478-483.
22.	Parks DA, Bulkley GB, Granger DN, et al. Ischemic injury in the cat small intestine: role of superoxide radicals [J]. Gastroenterology, 1982, 82(1): 9-15.
23.	Malbrain ML. Is it wise not to think about intraabdonimal hypertention in the ICU [J]. Curr Opin Crit Care, 2004, 10(2): 232-245.
24.	De Waele JJ, Leppäniemi AK. Intra-abdominal hypertension in acute pancreatitis [J]. World J Surg, 2009, 33(6): 1128-1133.
25.	De Waele JJ, Hoste E, Blot SI, et al. Intra-abdominal hypertension in patients with severe acute pancreatitis[J]. Crit Care, 2005, 9(4): 452-457.
26.	Keskinen P, Leppaniemi A, Pettila V, et al. Intra-abdominal pressure in severe acute pancreatitis [J].World J Emerg Surg, 2007, 2(1): 2-9.
27.	Caronna R, Benedetti M, Morelli A, et al. Clinical effects of laparotomy with perioperative continuous peritoneal lavage and postoperative hemofiltration in patients with severe acute pancreatitis [J]. World J Emerg Surg, 2009, 4: 45-51.
28.	Oda S, Hirasawa H, Shiga H, et al. Management of intra-abdominal hypertension in patients with severe acute pancreatitis with continuous hemodiafiltration using a polymethyl methacrylate membrane hemofilter [J]. Ther Apher Dial, 2005, 9(4): 355-361.
29.	Sun ZX, Huang HR, Zhou H. Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis [J]. World J Gastroenterol, 2006, 12(31): 5068-5070.
30.	Hobson KG, Young KM, Ciraulo A, et al. Release of abdominal compartment syndrome improves survival in patients with burn injuries [J]. J Trauma, 2002, 53(6): 1129-1134.
31.	Siebig S, Iesalnieks I, Bruennler T, et al. Recovery from respiratory failure after decompression laparotomy for severe acute pancreatitis [J]. World J Gastroenterol, 2008, 14(35): 5467-5470.
32.	Cheatham ML, Safcsak K, Llerena LE, et al. Long-term physical, mental, and functional consequences of abdominal decompression [J]. J Trauma, 2004, 56(2): 237-242.
33.	夏庆, 蒋俊明, 龚旭, 等. 通下法抗急性坏死性胰腺炎肺损害的实验研究[J]. 中国中西医结合外科杂志, 1997, 3(5): 336-339.
34.	蒋俊明, 张瑞明, 黄宗文, 等. 益活清下法治疗重症急性胰腺炎[J]. 中国中西医结合外科杂志, 1995, 1(1): 13-15.
35.	Zhang MJ, Zhang GL, Yuan WB, et al. Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine [J]. World J Gastroenterol, 2008, 14(22): 3574-3578.
36.	Tang WF, Yu Q, Wan MH, et al. Simultaneous determination and pharmacokinetic studies of aloe emodin and chrysophanol in rats after oral administration of Da-Cheng-Qi decoction by high-performance liquid chromatography[J]. Biomed Chromatogr, 2007, 21(7): 701-707.
37.	黄宗文, 夏庆, 陈光远, 等. 早期应用柴芩承气汤治疗重症急性胰腺炎临床疗效分析[J]. 成都中医药大学学报, 2003, 26(3): 25-26.
38.	谢基良, 张志尧, 吴咸中. 承气方剂对肠屏障功能保护作用的实验研究[J]. 中国中西医结合外科杂志, 2002, 8(3): 189-191.
39.	冯立民, 陈海龙, 关凤林. 阳明腑实证时内毒素与炎症介质的变化及复方大承气汤的治疗作用[J]. 中国中西医结合外科杂志, 2003, 9(5): 351-353.
40.	赵雾卿, 刘晓红. 大黄对急性胰腺炎多靶点的治疗作用[J]. Chin J Gastroenterol, 2003, 8(5): 316-617.
41.	马晓春. 清胰解毒汤治疗重症急性胰腺炎的临床研究[J]. 中国中西医结合消化杂志, 2002, 10(4): 223-224.
42.	李志新, 邱锦芳, 张忠. 通腑攻下法治疗重症急性胰腺炎合并腹腔间隔室综合征临床体会[J]. 新中医, 2004, 36 (10) : 33-34.
43.	张赘华, 郦岳. 大承气汤治疗腹腔间隔室综合征疗效观察[J]. 浙江中西医结合杂志, 2007, 17 (10): 612-613.
44.	Joynt GM, Gomersall CD. Intra-abdominal hypertension-an intensive care perspective[J]. Crit Care Shock, 2003, 6(3): 131-138.

1. 　De Waele JJ, De Laet I, Kirkpatrick AW, et al. Intra-abdominal hypertension and abdominal compartment syndrome [J]. Am J Kidney Dis, 2011, 57(1): 159-169.
2. 　De Waele JJ, Hesse UJ. Life saving abdominal decompression in a patient with severe acute pancreatitis [J]. Acta Chir Belg, 2005, 105 (1): 96-98.
3. 　Sugrue M, Jones F, Deane SA, et al. Intra-abdominal hypertension is an independent cause of postoperative renal impairment [J]. Arch Surg, 1999, 134(10): 1082-1085.
4. 　Al-Bahrani AZ, Darwish A, Hamza N, et al. Gut barrier dysfunction in critically ill surgical patients with abdominal compartment syndrome [J]. Pancreas, 2010, 39(7): 1064-1069.
5. 　De Waele JJ, Hoste E, Blot SI, et al. Intra-abdominal hypertension in patients with severe acute pancreatitis [J]. Crit Care, 2005, 9(4): 452-457.
6. 　Sanchez NC, Tenofsky PL, Dort JM, et al. What is normal intra-abdominal pressure? [J]. Am Surg, 2001, 67(3): 243-248.
7. 　Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration [J]. Ann Surg, 1983, 199(1): 28-33.
8. 　World Society of Abdominal Compartment Syndrome Consensus Conference Definitions. In: Inaugural World Congress-Abdominal Compartment Syndrome. 2004.
9. 　Malbrain ML, De laet I, Cheatham M. Consensus conference definitions and recommendations on intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) - the long road to the final publications, how did we get there? [J]. Acta Clin Belg, 2007(Suppl 1): 44-59.
10. 　Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions [J]. Intensive Care Med, 2006, 32: 1722-1732.
11. 　Dambrauskas Z, Parseliunas A, Gulbinas A, et al. Early recognition of abdominal compartment syndrome in patients with acute pancreatitis [J]. World J Gastroenterol, 2009, 15(6):717-721.
12. 　Marx G, Vangerow B, Burczyk C, et al. Evaluation of noninvasive determinants for capillary leakage syndrome in septic shock patients[J]. Intensive Care Med, 2000, 26 (9): 1252-1258.
13. 　Rezende-Neto JB, Moore EE, Melo de Andrade MV, et al. Systemic inflammatory response secondary to abdominal compartment syndrome: stage for multiple organ failure [J]. J Trauma, 2002, 53(6): 1121-1128.
14. 　De Waele JJ, Hesse UJ. Life saving abdominal decompression in a patient with severe acute pancreatitis [J]. Acta Chir Belg, 2005, 105(1): 96-98.
15. 　Mao EQ, Tang YQ, Fei J, et al. Fluid therapy for severe acute pancreatitis in acute response stage [J]. Chin Med J (Engl), 2009, 122(2): 169-173.
16. 　Zhang WF, Ni YL, Cai L, et al. Intraabdominal pressure monitoring in predicting outcome of patients with severe acute pancreatitis[J]. Hepatobiliary Pancreat Dis Int, 2007, 6(4): 420-423.
17. 　Chang MC, Miller PR, D’Agostino R Jr, et al. Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension [J]. J Trauma, 1998, 44(3): 440-445.
18. 　Obeid F, Saba A, Fath J, et al. Increases in intra-abdominal pressure affect pulmonary compliance [J]. Arch Surg, 1995, 130(5): 544-548.
19. 　Sugerman HJ, Bloomfield GL, Saggi BW. Multisystem organ failure secondary to increased intraabdominal pressure [J]. Infection, 1999, 27(1): 61-66.
20. 　Diebel LN, Dulchavsky SA, Wilson RF. Effect of increased intra-abdominal pressure on msenteric arterial and intestinal mucosal blood-flow [J]. J Trauma, 1992, 33(1): 45-49.
21. 　Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low-flow states [J]. Arch Surg, 1970, 101(4): 478-483.
22. 　Parks DA, Bulkley GB, Granger DN, et al. Ischemic injury in the cat small intestine: role of superoxide radicals [J]. Gastroenterology, 1982, 82(1): 9-15.
23. 　Malbrain ML. Is it wise not to think about intraabdonimal hypertention in the ICU [J]. Curr Opin Crit Care, 2004, 10(2): 232-245.
24. 　De Waele JJ, Leppäniemi AK. Intra-abdominal hypertension in acute pancreatitis [J]. World J Surg, 2009, 33(6): 1128-1133.
25. 　De Waele JJ, Hoste E, Blot SI, et al. Intra-abdominal hypertension in patients with severe acute pancreatitis[J]. Crit Care, 2005, 9(4): 452-457.
26. 　Keskinen P, Leppaniemi A, Pettila V, et al. Intra-abdominal pressure in severe acute pancreatitis [J].World J Emerg Surg, 2007, 2(1): 2-9.
27. 　Caronna R, Benedetti M, Morelli A, et al. Clinical effects of laparotomy with perioperative continuous peritoneal lavage and postoperative hemofiltration in patients with severe acute pancreatitis [J]. World J Emerg Surg, 2009, 4: 45-51.
28. 　Oda S, Hirasawa H, Shiga H, et al. Management of intra-abdominal hypertension in patients with severe acute pancreatitis with continuous hemodiafiltration using a polymethyl methacrylate membrane hemofilter [J]. Ther Apher Dial, 2005, 9(4): 355-361.
29. 　Sun ZX, Huang HR, Zhou H. Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis [J]. World J Gastroenterol, 2006, 12(31): 5068-5070.
30. 　Hobson KG, Young KM, Ciraulo A, et al. Release of abdominal compartment syndrome improves survival in patients with burn injuries [J]. J Trauma, 2002, 53(6): 1129-1134.
31. 　Siebig S, Iesalnieks I, Bruennler T, et al. Recovery from respiratory failure after decompression laparotomy for severe acute pancreatitis [J]. World J Gastroenterol, 2008, 14(35): 5467-5470.
32. 　Cheatham ML, Safcsak K, Llerena LE, et al. Long-term physical, mental, and functional consequences of abdominal decompression [J]. J Trauma, 2004, 56(2): 237-242.
33. 　夏庆, 蒋俊明, 龚旭, 等. 通下法抗急性坏死性胰腺炎肺损害的实验研究[J]. 中国中西医结合外科杂志, 1997, 3(5): 336-339.
34. 　蒋俊明, 张瑞明, 黄宗文, 等. 益活清下法治疗重症急性胰腺炎[J]. 中国中西医结合外科杂志, 1995, 1(1): 13-15.
35. 　Zhang MJ, Zhang GL, Yuan WB, et al. Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine [J]. World J Gastroenterol, 2008, 14(22): 3574-3578.
36. 　Tang WF, Yu Q, Wan MH, et al. Simultaneous determination and pharmacokinetic studies of aloe emodin and chrysophanol in rats after oral administration of Da-Cheng-Qi decoction by high-performance liquid chromatography[J]. Biomed Chromatogr, 2007, 21(7): 701-707.
37. 　黄宗文, 夏庆, 陈光远, 等. 早期应用柴芩承气汤治疗重症急性胰腺炎临床疗效分析[J]. 成都中医药大学学报, 2003, 26(3): 25-26.
38. 　谢基良, 张志尧, 吴咸中. 承气方剂对肠屏障功能保护作用的实验研究[J]. 中国中西医结合外科杂志, 2002, 8(3): 189-191.
39. 　冯立民, 陈海龙, 关凤林. 阳明腑实证时内毒素与炎症介质的变化及复方大承气汤的治疗作用[J]. 中国中西医结合外科杂志, 2003, 9(5): 351-353.
40. 　赵雾卿, 刘晓红. 大黄对急性胰腺炎多靶点的治疗作用[J]. Chin J Gastroenterol, 2003, 8(5): 316-617.
41. 　马晓春. 清胰解毒汤治疗重症急性胰腺炎的临床研究[J]. 中国中西医结合消化杂志, 2002, 10(4): 223-224.
42. 　李志新, 邱锦芳, 张忠. 通腑攻下法治疗重症急性胰腺炎合并腹腔间隔室综合征临床体会[J]. 新中医, 2004, 36 (10) : 33-34.
43. 　张赘华, 郦岳. 大承气汤治疗腹腔间隔室综合征疗效观察[J]. 浙江中西医结合杂志, 2007, 17 (10): 612-613.
44. 　Joynt GM, Gomersall CD. Intra-abdominal hypertension-an intensive care perspective[J]. Crit Care Shock, 2003, 6(3): 131-138.

West China Medical Journal

重症急性胰腺炎与腹腔室隔综合征的研究进展

Abstract Full text Figures/Tables Video References Cited by

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