CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究(附43例报道)  

Clinical Study on CT Guided Puncture to The Diagnosis and Treatment of Local Complications of Severe Acute Pancreatitis(Report of 43 Cases)

作　　者：姚欣敏[1] 于澜[1] 张抒[1] 肖渝清[1] 杨一村[1] 曹扬[1] 黄江涛[1] 黄德全[1] 罗静[1] 彭秋生[1] 

机构地区：[1]成都市第三人民医院普外科肝胆胰研究室,成都610031

出　　处：《中国普外基础与临床杂志》2008年第8期560-563,566,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：成都市卫生局重大科研课题2003-2004(编号:10)~~

摘　　要：目的探讨CT引导下经皮穿刺抽液检查和(或)置管外引流在重症急性胰腺炎(severe acute pancre-atitis,SAP)局部并发症中的诊治价值。方法对我院2003年3月至2008年2月期间收治43例合并胰腺坏死、胰周积液、假性胰腺囊肿及脓肿并发症的SAP患者进行了CT引导下经皮穿刺抽液检查和(或)置管外引流,观察其疗效。结果43例SAP患者共穿刺64例次,穿刺成功率为100%。其中24例行诊断性穿刺抽液检查,诊断符合率为100%。41例(95%)置管引流48例次,1例直接行开腹手术,1例自动出院。腹胀缓解率为93%(40/43),中转开腹手术率为37%(16/43),置管外引流有效率为61%(25/41)。结论采用CT引导下穿刺抽液检查和(或)置管外引流对部分SAP患者局部并发症的诊治效果较好。Objective To explore the value of CT guided percutaneous puncture, aspiration and drainage on diagnosis and treatment of local complications of severe acute pancreatitis （SAP）. Methods Forty-three cases of SAP combined with pancreatic necrosis, peripancreatic hydrops, pseudocyst and abscess were analyzed, all of them underwent CT guided percuta-neous puncture, aspiration and drainage. Results The punctures were performed on 43 SAP patients for sixty-four times, the success rate was 100%, and in 24 cases of them puncture were peHormed for diagnosis, the positive rate of fluid absorption by puncture was 100%. Forty-one of 43 cases （95%） received puncture and tube drainage, open operation was performed in one patient, one patient was automatically discharged. The remission rate of abdominal distension was 93% （40/43） and 16 of 43 cases （37%） were turned to open operation. The effective rate of drainage was 61% （25/41）. Conclusion The puncture, aspiration and drainage guided by CT is an effective method in diagnosis and treatment of local complications in part of SAP cases.

关 键 词：重症急性胰腺炎 CT引导 穿刺 抽液 置管引流 

分 类 号：R657.51[医药卫生—外科学]