早期腹腔穿刺置管灌洗引流在急性重症胰腺炎治疗中的应用  

作　　者：邹伟清[1] 吴建维[1] 林丽嫚[1] 赖四海[1] 

机构地区：[1]南方医科大学附属深圳宝安医院消化内科,518101

出　　处：《浙江临床医学》2013年第2期151-153,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨超声引导下经皮穿刺置管引流术在早期重症急性胰腺炎的临床应用价值。方法重症胰腺炎患者60例随机分为置管灌洗引流治疗（观察组）32例和传统手术治疗（对照组）28例，对两组患者的疗效及治疗前后实验室检查指标进行对比分析。结果观察组治愈率68．75％，总有效率87．50％，对照组治愈率46．43％，总有效率64．29％，两两比较差异均有统计学意义；病死率观察组3．13％，对照组21．43％，两者比较差异有统计学意义（P〈0．05）；观察组患者症状消失时间、饮食恢复正常时间以及住院天数等与对照组相比差异有统计学意义；观察组血淀粉酶、尿淀粉酶、血糖、血钙、白细胞计数等实验室检查指标与对照组相比差异也有统计学意义（P〈O．05）。结论超声引导置管灌洗引流能够缓解重症急性胰腺炎患者的腹腔高压症状，提高治愈率，降低并发症和病死率，较传统手术治疗方法效果好，且简单易行，具有较好的临床应用价值。Objective To explore the clinical value of ultrasound-guided percutaneous tube drainage in treatment for severe acute pancreatitis. Methods 60 Patients with severe acute pancreatitis January in 2009 to December in 2011 were randomly divided into two groups which were treated with ultrasonie-guided pereutaneous catheter drainage and lavage （ n=32 ） and traditional surgery （ n=28 ） respectively. Laboratory data of both groups were obtained before and after treatment; recovery, efficacy after treatment and mortality were compared between these two groups; medical statistics analysis were made. Results The total effective rate was 87.50% in observation group, higher than 64.29% in control group （ P〈0.05 ） , the cure rate was 68.75% in observation group, higher than 46.43% in control group （ P〈0.05 ） , the mortality rate of theobservation group was 3.13%, lower than 21.43% in control group （P〈0.05） , The symptoms disappeared time, the time of regular diet and average hospitalization day were obviously different between the observation group and control group （ P〈0.05 ） . The serum or urineamylase, glucose, serumcalcium andwhite blood cell count were obviously different between the observation group and control group too （ P〈0.05 ） .Conclusions Ultrasound-guided tube drainage and lavage treatment can relieve symptoms in patients with SAP, improve the cure rate and the prognosis of patients with SAP, reduce the incidence of complications and mortality and shorten the course.Inaword, Ultrasound tube drainage and lavage treatment is more effective than traditional surgery for clinical treatment of severe acute pancreatitis.

关 键 词：重症急性胰腺炎 腹腔灌洗 经皮腹腔穿刺引流 

分 类 号：R657.51[医药卫生—外科学]