经皮胆囊穿刺引流术辅助治疗重症急性胰腺炎的临床应用价值  

Clinical Application of Percutaneous Gallbladder Drainage in Severe Acute Pancreatitis

作　　者：谢锋[1] 朱芳[2] 王红岩[3] 刘峥嵘[3] 赵晓丹[3] 樊小刚 韩宏民 

机构地区：[1]中国医科大学人民医院核医学科,沈阳110016 [2]中国医科大学人民医院心功能科,沈阳110016 [3]中国医科大学人民医院普外科,沈阳110016 [4]沈阳出入境检验检疫局国际旅行卫生保健中心,沈阳110016

出　　处：《中国医科大学学报》2018年第3期244-246,共3页Journal of China Medical University

基　　金：辽宁省社会发展公关计划(2013225021)

摘　　要：目的探讨采用经皮胆囊穿刺引流术辅助治疗重症急性胰腺炎的临床应用价值。方法回顾性分析65例重症胰腺炎患者的临床资料。将患者分为胆囊穿刺组和对照组。随访至少6个月,观察2组的死亡率及胰腺脓肿、假性囊肿、肾功能不全、呼吸衰竭、心功能衰竭、消化道出血、败血症、弥漫性血管内凝血(DIC)等并发症的发生率,并进行统计学分析比较。结果胆囊穿刺组死亡率低于对照组,差异有统计学意义(P<0.05);胆囊穿刺组全身并发症(肾功能不全、呼吸衰竭、心力衰竭、消化道出血、败血症)的发生率低于对照组(P<0.05);胆囊穿刺组局部并发症(胰腺脓肿及假性囊肿)的发生率与对照组无统计学差异(P>0.05);另外,胆囊穿刺组DIC的发生率低于对照组,但差异无统计学意义(P>0.05)。结论经皮胆囊穿刺引流术能够有效降低重症胰腺炎的肾功能不全、呼吸衰竭、心功能衰竭、消化道出血、败血症等全身并发症的发生率,降低死亡率。但对于局部并发症胰腺脓肿和假性囊肿及DIC的发生率没有帮助。Objective To investigate the clinical value of percutaneous gallbladder drainage in the treatment of severe acute pancreatitis（SAP）. Methods A total of 65 patients treated for SAP in our hospital between January 2014 and April 2017 were analyzed retrospectively. The patients were divided into a gallbladder puncture group and a control group. Follow-up was performed for at least 6 months to monitor mortality and the incidence of complications,including pancreatic abscess,pseudocyst,renal failure,respiratory failure,heart failure,gastrointestinal bleeding,sepsis,and disseminated intravascular coagulation（DIC）. The differences in mortality and complication rates between the two groups were statistically analyzed. Results Mortality in the gallbladder puncture group was significantly lower than in the control group（P 0.05）;the incidence of renal failure,respiratory failure,heart failure,gastrointestinal bleeding,and sepsis in the gallbladder puncture group was lower than in the control group（P 0.05）;the incidence of pancreatic abscess and pseudocyst in the gallbladder puncture group was similar to that in the control group,showing no significant difference（P 0.05）;the incidence of DIC in the gallbladder puncture group was lower than in the control group,but the difference was not statistically significant（P 0.05）. Conclusion Percutaneous gallbladder drainage can effectively reduce the incidence of renal failure,respiratory failure,heart failure,gastrointestinal bleeding,and sepsis in SAP,thereby reducing mortality. However,the incidence of DIC,pancreatic abscess,and pseudocyst is not reduced.

关 键 词：经皮胆囊穿刺引流术 重症胰腺炎 死亡率 全身并发症 局部并发症 

分 类 号：R45[医药卫生—治疗学]