介入超声在治疗重症急性胰腺炎中的应用  

Application of interventional ultrasound in the treatment of severe acute pancreatitis

作　　者：曾志雄[1] 姚玉珍[1] 余卫峰 张长青[2] 孙安毅[1] 

机构地区：[1]福建省泉州市第一医院超声科,福建泉州362000 [2]福建省泉州市第一医院消化内科,福建泉州362000

出　　处：《医学影像学杂志》2016年第5期856-859,共4页Journal of Medical Imaging

基　　金：福建医科大学非直属附属医院科研发展专项基金资助项目;医大科技(2013)37号(项目编号:FZS13026Y)

摘　　要：目的分析重症急性胰腺炎并腹腔高压早期行腹腔穿刺置管引流的临床效果以及其在临床应用的价值。方法回顾性研究我院2005年5月-2015年5月确诊的重症急性胰腺炎并腹腔高压患者214例,按照治疗方法分为观察组（110例）与对照组（104例）,观察组采用介入超声治疗方法,对照组采用保守治疗方法,比较两组患者相关临床指标、疗效评价指标、医疗资源的使用、并发症发生率及病死率。结果两组患者治疗前一般资料（年龄、性别、发病原因）具有可比性。观察组患者疗效评价指标（症状、体征消失时间、血淀粉酶恢复正常的时间、恢复饮食时间）均优于对照组患者〔平均值分别为（8.3±2.5）天比（12.4±2.9）天,（5.2±1.73）天比（7.1±2.1）天,（7.9±2.4）天比（11.9±3.1）天,P〈0.05）〕,观察组患总住院时间和住院费用均低于对照组（平均值分别为〔（17.9±4.6）天比（22.4±5.2）天,（181 862±6091）元比（273691±11836）元,P〈0.05〕,两组治疗后膀胱压均呈下降趋势,但观察组膀胱压下降速度较对照组快（P〈0.05）,观察组患者并发症发生率明显低于对照组患者（分别为17.3%比34.6%,P〈0.05）,两组患者治疗有效率差异有统计学意义（分别为90.0%比77.9%,P〈0.05）,两组患者病死率因病例原因差异无统计学意义（分别为2.7%比6.7%,P〉0.05）。结论早期腹腔穿刺引流可以降低重症急性胰腺炎并腹腔高压患者的腹腔内压力,并发症发生率,并缩短病程,降低患者平均住院费用,并延缓及阻止病情的发展。Objective To analyze the clinical effect and its application value of percutaneous catheter drainage in treatment for the early stage of severe acute pancreatitis（ SAP） accompanied with abdominal cavity effusion（ IAH）. Methods We retrospectively investigated 214 patients,who suffered from SAP with IAH in our hospital from May 2005 to May 2015. According to the therapeutical approaches,those enrolled patients were divided into two groups,i. e.,the observation group（ 110） and control（ 104） group. Patients in observation team were treated by ultrasonic therapy,and the others were treated by conservative therapy.Then,the related clinical parameters,the curative effect,the use of medical resources,the incidence of complications,and death rate were compared between the two groups. Results The general data,in terms of age,gender,and etiology,for each patient in two groups before treatment were comparable. The parameters for the evaluation of the curative effect,such as symptoms,the time of sign disappearance,the time of blood amylase came back to normal level,and the time for going back to eating normally again of patients in observation group were superior to those in control group. The average data were（ 8. 3 ± 2. 5） d vs（ 12. 4 ± 2. 9） d,（ 5. 2 ± 1. 73） d vs（ 7. 1 ± 2. 1） d,and（ 7. 9 ± 2. 4） d vs（ 11. 9 ± 3. 1） d,respectively（ all P〈0. 05）. The total duration in hospital and hospital cost in observation group were lower than those in control group. The average data were（ 17. 9 ± 4. 6） d vs（ 22. 4 ± 5. 2） d,（ 181 862 ± 6091） $ vs（ 273 691 ± 11 836） $,（ P〈0. 05）. The bladder pressure of patients in both groups showed a decrease tendency,but,the rate of descent for bladder pressure in observation group was faster than that in control group（ P〈0. 05）. Besides,the incidence of complication in observation group was significantly lower than that in control group（ 17. 3% vs 34. 6%,P〈0. 05）. The curative effect between the two groups was

关 键 词：超声 穿刺引流术 重症急性胰腺炎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R576[医药卫生—诊断学]