经皮置管引流治疗重症急性胰腺炎合并胰腺坏死组织感染34例分析  

Percutaneous catheter drainage for severe acute pancreatitis complicated with infective pancreatic necrosis: an analysis of 34 cases

作　　者：童智慧[1] 李维勤[1] 虞文魁[1] 王新颖[1] 叶向红[1] 聂垚[1] 柯路[1] 徐晓帆[1] 鲁俊[1] 倪海滨[1] 孙加奎[1] 李宁[1] 黎介寿[1] 

机构地区：[1]南京大学医学院南京军区南京总医院普通外科研究所,江苏南京210002

出　　处：《中国实用外科杂志》2011年第11期1041-1044,共4页Chinese Journal of Practical Surgery

摘　　要：目的分析经皮置管引流(percutaneous catheter drainage,PCD)治疗重症急性胰腺炎(severe acute pancreatitis,SAP)合并胰腺坏死组织感染的临床效果及影响因素。方法回顾性分析2008年1月至2010年2月南京军区南京总医院普通外科应用PCD治疗34例胰腺坏死组织感染的临床资料。根据PCD治疗效果将34例SAP病人分为PCD治疗成功组和PCD治疗变更组,比较两组病人全身状况、局部病变以及PCD治疗过程的差异。结果19例经PCD治疗成功,成功率55.9%。两组病人胰腺坏死组织感染的CT密度平均值、CT分布范围值等方面比较差异有统计学意义(P<0.01)。结论胰腺坏死组织感染的CT密度平均值和CT分布范围值均为PCD治疗胰腺坏死组织感染的影响因素,其值越大,失败的风险性越高,不适合行PCD治疗。反之则建议首选PCD治疗。Objective To analyze the clinical effectiveness of pereutaneous US- or CT- guided catheter drainage （PCD） for severe acute pancreatitis complicated with infective pancreatic necrosis and the possible influencing factors. Methods The clinical data of 34 cases of infective pancreatic necrosis treated by PCD from January 2008 to February 2010 in Jinling Hospital, Medicine School of Nanjing University were analyzed retrospective. All of them received PCD as the first choice for treatment. After that, they were divided into two groups according to different clinical effectiveness of PCD. The two groups were compared for demographics, systemic and local complications and clinical outcomes. Results Ninteen of the 34 cases were cured through PCD alone （55.9%）. Additionally, the number of catheter used for drainage and bacterial culture result were also similar between the two groups. Only the CT value and distribution range of infective pancreatic necrosis were different between them. The logistic regression analysis revealed similar results too. Conclusion The CT value and distribution range of infective pancreatic necrosis could influence the success rate of PCD significantly and should be serious considered before the treatment decision.

关 键 词：胰腺炎 胰腺坏死组织感染 经皮置管引流 

分 类 号：R6[医药卫生—外科学]