早期多时点多部位B超引导下穿刺置管引流联合血液净化治疗高脂血症性重症急性胰腺炎的疗效  

Effect of B Ultrasound-Guided Percutaneous Catheter Drainage Combined with Veno-Venous Hemofiltration at Different Time Points and Multi-Site in Treatment of Hyperlipidemic Severe Acute Pancreatitis

作　　者：骆永富[1,2] 曾之耀 王湘英[2] 张兴文[2] 卢义展 

机构地区：[1]湖南省永州市中心医院普外科,湖南永州425000 [2]湖南省人民医院肝胆胰外科,湖南长沙410005 [3]湖南省湘西自治州人民医院普外科,湖南湘西吉首416000

出　　处：《中国普外基础与临床杂志》2015年第1期33-36,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨早期多时点多部位B超引导下穿刺置管引流联合血液净化治疗高脂血症性重症急性胰腺炎的疗效。方法回顾性分析2010年1月至2014年6月期间湖南省人民医院收治的34例高脂血症性重症急性胰腺炎患者的临床资料,根据发病至就诊时间的不同分为≤24 h组和>24 h组,均予以早期多时点多部位B超引导下穿刺置管引流联合血液净化治疗,分别测定入院时及入院后第1、3、5、7和10天的血小板活化因子(PAF)及甘油三酯(TG)水平,并观察患者的住院时间、死亡率和转开腹手术率。结果 2组患者入院后各时点的PAF和TG水平均较入院时均明显下降(P<0.05),且≤24 h组患者的PAF和TG下降的水平较>24 h组要低些;≤24 h组患者的住院时间明显短于>24 h组(P<0.05),死亡率及转开腹手术率均低于>24 h组(P<0.05)。结论早期多时点和多部位B超引导下穿刺引流联合血液净化,在高脂血症性重症急性胰腺炎及其合并症的治疗中具有较大的应用价值。Objective To investigate the therapeutic effect of B ultrasound-guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site in treatment of hyperlipidemic severe acute pancreatitis （HL-SAP）. Methods The clinical data of 34 patients with HL-SAP initially underwent B ultrasound- guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site from January 2010 to June 2014 were retrospectively analyzed. According to the different of the onset to treatment time, 34 cases were divided into the ≤ 24 h group and 〉24 h group. The serum platelet activating factor （PAF） and triglyceride （TG） at the time of admission and after admission I, 3, 5, 7, and 10 days were detected, and the hospitalization time, mortality, and the rate of conversion to open surgery were observed. Results The levels of PAF and TG in the both groups tended to gradually decrease with different degrees, were significantly lower than that the before treatment （P〈0.05）, and the decline of PAF and TG in ≤ 24 h group were more significant than 〉24 h group. The hospitalization time, mortality, and the rate of conversion to open surgery in the ≤ 24 h group were significantly lower than those of the 〉24 h group （P〈0.05）. Conclusion The early using of B ultrasound-guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site would have a beneficial impact on the management of HL-SAP and complications.

关 键 词：B超引导 穿刺置管引流 血液净化 高脂血症性重症急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]