经皮穿刺置管引流治疗急性胰腺炎胰周积液的价值分析  

Applied value of percutaneous catheter drainage in treatment of acute pancreatic fluid collection

作　　者：王伟[1] 项和平[1] 朱立新[2] 

机构地区：[1]安徽医科大学第二附属医院急诊外科,合肥238300 [2]安徽医科大学第一附属医院外科教研室

出　　处：《腹部外科》2012年第6期356-358,共3页Journal of Abdominal Surgery

摘　　要：目的探讨经皮穿刺置管引流（percutaneouscatheterdrainage，PCD）在治疗急性胰腺炎胰周积液的临床应用价值。方法2（）（）9年10月至20t1年12月行PCD治疗的急性胰腺炎胰周积液3（）例，其中急性液体积聚23例次，胰腺坏死8例次，胰腺假性囊肿5例次，胰腺脓肿2例次。检查穿刺液是否伴感染，随访临床症状、并发症、引流效果及影像学的改变。结果共穿刺74例次，9例引流液培养为单一菌，6例为混合菌。治疗成功23例（76．7％），部分缓解后中转手术7例（23．3％）。出现并发症1（）例，胰外瘘8例，腹腔内出血2例，1例继发感染。结论急性胰腺炎胰周积液应根据病情实施个体化的综合性治疗。经皮穿刺置管引流成功率高，病死率低，应掌握好作为确定性介入治疗适应证。Objective To explore the clinically applied value of percutaneous catheter drainage （PCD） for pancreatic fluid collection in acute pancreafitis. Methods The clinical data of 30 cases of pancreatic fluid collection caused by acute pancreatitis subject to PCD from Oct. 2009 to Dec. 2011, including 23 cases of acute accumulation of fluid, 8 cases of pancreatic necrosis, 5 cases of pancreatic pseudocyst, and 2 cases of pancreatic ahcesses, were retrospectively analyzed. Results There were 74 cases/times of PCD in 30 patients. Twenty-three cases were curred successfully （76. 7%）. Seven ea- ses, including 3 cases of pancreatic necrosis, 2 cases of infected pancreatic pseudocyst and 2 cases of panreatic abscess, felt release of abdomina] distention, but the result was poor and then they received surgery. Complications occurred in 10 cases, including 8 cases of pancreatic fistula, 2 cases of bleeding and 1 case of infection. Conclusion The comprehensive treatment to the pancreatic fluid collection af- ter acute pancreatitis should be individualized according to the condition. PCD is a minimally invasive technique with high successful rate and low death rate, but as a deterministic intervention, its indica tions should be considered.

关 键 词：胰腺炎 急性坏死性 水肿 胰腺假囊肿 脓肿 引流术 

分 类 号：R657.5[医药卫生—外科学]