超声引导下经皮穿刺置管引流治疗重症急性胰腺炎急性胰周液体积聚的临床疗效

目的:探讨超声引导下经皮穿刺置管引流(PCD)治疗重症急性胰腺炎(SAP)急性胰周液体积聚的的临床疗效。方法:收集2009年3月~2013年10月我院收治的经临床确定的SAP急性胰周液体积聚患者51例,按随机数字表法分为观察组(26例)和对照组(25例),观察组患者给予超声引导下经皮穿刺置管引流术治疗,对照组采用剖腹引流的经典引流。比较两组患者血淀粉酶恢复至时间、住院时间、治愈率、并发症发生率。结果:观察组血淀粉酶恢复时间及住院时间均小于对照,差异有统计学意义(P0.05);观察组患者总有效率位96.2%(25/26),高于对照组的68.0%(17/25),两组比较组间差异有统计学意义(P0.05);观察组治疗后病死、腹腔出血、胰瘘发生率高于对照组(均P0.05);两组脓毒症及多器官功能障碍综合症(MODS)的比较差异无统计学差异(P0.05)结论:超声引导下经皮穿刺置管引流术治疗SAP急性胰周液体积聚效果良好,并发症的低,安全可靠,具有较大的临床推广价值。

Effects of Ultrasound-guided Percutaneous Catheter Drainage for Severe Acute Pancreatitis with Peripancreatic Fluid Collections

Objective:To explore the effects of ultrasound-guided percutaneous catheter drainage for treatment of severe acute pancreatitis(SAP) with peripancreatic fluid collections.Methods:51 cases of SAP patients with peripancreatic fluid collections who were treated in our hospital from March 2009 to October 2013 were randomly divided into observation group (26 cases) and control group (25 cases), according to the random number table method. The observation group received ultrasound-guided percutaneous catheter drainage, while the classical caesarean drainage methods were used to the control group. Recovery time of blood amylase, hospitalization time, total effective rate and incidence of complications of two groups were compared.Results:Recovery time of blood amylase and the hospitalization time of the observation group were less than that of the control group, the difference was statistically significant (P<0.05); the total effective rate of the observation group was 96.2%(25/26), higher than 68% (17/25) of the control group (P<0.05); After treatment, the incidence of abdominal bleeding, mortality pancreatic fistula was higher than that of the control (P<0.05); Sepsis and multiple organ dysfunction syndrome (MODS) showed no significant difference IN in the two groups(P>0.05).Conclusion:Ultrasoundguided percutaneous catheter drainage is safe and reliable and has good effect in the treatment of SAP with peripancreatic fluid with few complication, it has great clinical value.