Clinical effect of early bowel-relaxing treatment and drainage in treatment of severe acute pancreatitis with intra-abdominal hypertension

Objective To investigate the clinical effect of early bowel- relaxing treatment and drainage in the treatment of severe acute pancreatitis( SAP). Methods A retrospective analysis was performed for the clinical data of 52 patients with SAP who were admitted to Department of Hepatopancreatobiliary Surgery,Zhuzhou Central Hospital,from January 2009 to January 2015,and these patients were divided into conventional treatment group with 22 patients and early bowel- relaxing / drainage group with 30 patients. The incidence of multiple organ dysfunction syndrome and abdominal compartment syndrome within 2 weeks,time to intra- abdominal pressure reduced to below 15 cm H2 O,time to gastrointestinal function recovery,pancreatic infection rate,and mortality rate were compared between the two groups. The independent samples t- test was used for comparison of continuous data between the two groups,and the chi- square test was used for comparison of categorical data. Results Compared with the conventional treatment group,the early bowel- relaxing / drainage group had significant reductions in the incidence rates of multiple organ dysfunction syndrome( 31. 8% vs 10. 0%,χ2= 3. 89,P = 0. 049) and abdominal compartment syndrome( 22. 7% vs 3. 3%,χ2= 4. 68,P = 0. 031) within 2 weeks,pancreatic infection rate( 40. 9% vs 13. 3%,χ2= 5. 15,P= 0. 023),and mortality rate( 22. 7% vs 3. 3%,χ2= 4. 68,P = 0. 031). Compared with the conventional treatment group,the early bowel- relaxing / drainage group had significantly shortened time to intra- abdominal pressure reduced to below 15 cm H2 O,time to bowel sound recovery,and time to the recovery of passing of flatus and defecation( t = 1. 02,6. 67,and 2. 13,all P < 0. 01). Conclusion In the early stage of SAP,bowel- relaxing treatment and drainage can effectively reduce intra- abdominal hypertension,protect vital organ function,alleviate the condition of SAP,reduce the incidence of complications,and thus significantly improve the prognosis of SAP.