选择性动脉置管药物灌注治疗重症急性坏死性胰腺炎的临床研究  

Clinical study of intra-arterial infusion of drugs through selective arterial catheterization in the treatment of acute necrotizing pancreatitis

作　　者：吴渭贤[1] 朱希松[1] 江朝根[1] 吴显清[1] 余耀生[1] 

机构地区：[1]浙江省衢州市人民医院放射科,浙江衢州324000

出　　处：《中国中西医结合急救杂志》2007年第5期281-283,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省衢州市科技计划基金资助项目(2001040)

摘　　要：目的：评价经动脉选择性动脉置管采用微泵持续药物灌注治疗急性坏死性胰腺炎（ANP）的疗效。方法：选择57例ANP患者，经超声、CT或磁共振成像（MRI）确诊后立即实施选择性动脉插管，然后接微泵作持续性药物灌注，药物用量为思他宁3mg／d，丹参注射液20ml／d，头孢噻肟钠3g／d，用生理盐水稀释后24h不间断交替缓慢给药，连续3～9d。观察发病至不同插管时间患者的置管时间及住院时间。结果：57例ANP患者经过17～35d治疗全部治愈出院，均未发生严重并发症或后遗症。发病至插管时间与患者置管时间和住院时间成正比，其中发病至插管时间〈12h置管时间平均（3．7±0．8）d，住院时间平均（22．6±2．8）d；发病至插管时间〉48h置管时间平均（7．2±1．2）d，住院时间平均（32．0±3．6）d；说明发病至插管时间越短，疗效越显著。结论：经选择性动脉置管药物灌注治疗ANP疗效肯定，治疗时间短，是一种比较理想的治疗方法。Objective： To evaluate the therapeutic effect of continuous intra -arterial infusion of drugs using micro -pump through selective arterial catheterization in the treatment of acute necrotizing pancreatitis （ANP）. Methods： Fifty -seven patients with ANP were treated with intra -arterial infusion of drugs through selective arterial catheterization immediately after the diagnosis was confirmed by ultrasonography （US）, CT or magnetic resonance imaging （MRI）. The drugs included somatostatin 3 mg per day, salvia miltiorrhza extract 20 ml per day, cefotaxime sodium 3 g per day, diluted with normal saline. The drugs were injected alternatively throughout 24 hours every day for 3 - 9 days using micro - pumps. The relationship of the time from onset of the disease to catheterization and length of indwelling catheter and hospital stay were observed. Results ： All of the 57 patients recovered after 17 - 35 days＇ treatment. No severe complications or sequelae were observed. Time from onset of the disease to catheterization （〈12 hours or 〉48 hours） was positively correlated with patients＇ mean catheterization time [（3.7±0.8） days or （7.2±1.2） days, respectively] and hospital stay [（22.6±2.8） days or （32.0±3.6） days, respectively）. The findings suggested that the shorter the time between the onset of the disease and catheterization was, the better the curative effect was. Conclusion： The continuous intra - arterial infusion of drugs using micro - pump through selective arterial catheterization offers good therapeutic effect for ANP. It can shorten the duration of treatment and is proved to be an ideal method for the treatment of ANP.

关 键 词：动脉置管 选择性 药物灌注 胰腺炎 坏死性 急性 

分 类 号：R657.51[医药卫生—外科学]