超声或CT引导经皮置管引流治疗感染性坏死性胰腺炎31例分析  

Ultrasound or CT-guided percutaneous catheter drainage for treatment of infected necrotizing pancreatitis:an analysis of 31 cases

作　　者：陈焕伟[1] 崔伟珍[1] 甄作均[1] 张海雄[1] 杨少仪[1] 

机构地区：[1]广东省佛山市第一人民医院肝胆外科,广东佛山528000

出　　处：《中国实用外科杂志》2007年第12期966-968,共3页Chinese Journal of Practical Surgery

基　　金：佛山市科技攻关项目(No:200508049);中华医学会胰腺外科科研项目

摘　　要：目的评价超声或CT引导经皮置管引流治疗急性感染性坏死性胰腺炎和胰周积液的有效性和安全性。方法回顾性分析2002年1月至2006年12月广东省佛山市第一人民医院收治的31例急性感染性坏死性胰腺炎的病例资料。全部病人均实施超声或CT引导下经皮穿刺置管引流胰周感染性积液。结果31例病人中，25例通过经皮置管引流后成功治愈，置管引流治愈率为80.6％（25／31），2例死亡（分别死于脑出血和呼吸以及肾功能衰竭）；4例引流失败，行外科手术引流，2例痊愈，2例死于多器官功能衰竭，总治愈率为87.1％（27／31）。总病死率为12．9％（4／31）；引流时间7～90d，平均23d，引流次数1～4次，无导管相关性并发症发生。结论对于急性感染性坏死性胰腺炎和胰周积液经皮置管引流是一种安全有效的治疗方法，对于大部分选择适当的病例，可以避免传统外科手术引流。Objective To investigate the efficacy and safety of percutaneous ultrasound or CT-guided catheter drainage for treatment of acute infected necrotizing pancreatitis and peripancreatic fluid collections. Methods The clinical data of 31 patients with acute infected necrotizing pancreatitis admitted between January 2002 and December 2006 in the First People＇ s Hospital of Foshan was analyzed retrospectively. All of patient with peripancreatic infected fluid collections were treated with ultrasound or CT-guided percutaneous catheter drainage. Results Twenty-five of the 31 patients were cured with percutaneous catheter drainage with the cure rate of 80. 6% （25/31）. Two patients died with one from intracerebral hemorrhage and one from respiratory and renal failure. Four patients failed to required sUrgery drainage. Among them, two patients recovery and two died from muhiorgan failure. The total cure rate was 87. 1% （27/31）. The total mortality was 12.9% （4/31）. The drainage duration time was from 7 to 90 days （ mean 23 days）~ The drainage was performed for one to four times No catheter-related complications occurred. Conclusion Percutaneous catheter drainage is a safe and effective technique for treating acute infected necrotizing pancreatitis and peripancreatic fluid collections. It can avoid conventional surgery drainage for most of selected patients.

关 键 词：B超 CT 经皮胰周引流 急性感染坏死性胰腺炎 

分 类 号：R6[医药卫生—外科学]