重症急性胰腺炎合并大量胰周积液的治疗体会  

Experience in the treatment of severe acute pancreatitis with a large amount of peripancreatic effusion

作　　者：李贺[1] 孙远松 宋凯 尹纯林[1] 汪海平[1] 王召华[1] 闵安 李申涛 尹冉 LI He;SUN Yuansong;SONG Kai(The Second Hospital of Anhui Medical University, Hefei 230601, China)

机构地区：[1]安徽医科大学第二附属医院急诊外科

出　　处：《肝胆外科杂志》2019年第2期122-124,共3页Journal of Hepatobiliary Surgery

基　　金：安徽省自然科学基金(1508085SMH225)

摘　　要：目的对18例重症急性胰腺炎合并大量胰周积液的患者进行穿刺置管引流和“升阶梯式”策略进行治疗,并进行疗效评价.结果显示,18例患者共进行28例次置管引流.所有患者穿刺过程顺利,无明显出血、脏器损伤、肠瘘等严重并发症.其中5例患者行单腔置管引流后临床症状缓解,腹腔积液消失.13例患者行多次置管引流,其中1例患者后期联合胆道镜下行坏死组织清除术,1例患者行手术治疗,18例患者全部治愈出院.表明应用穿刺置管引流和“升阶梯式”策略对重症急性胰腺炎合并大量胰周积液的治疗安全有效,值得在临床应用推广.Objective 18 cases of severe acute pancreatitis with massive peripancreatic effusion were treated with puncture and drainage and " step up" strategy,and the curative effect was evaluated. The results showed that 18 patients underwent 28 times tube drainage. All patients had a smooth puncture, and no significant bleeding, organ injury, intestinal fistula and other serious complications. In 5 cases, the clinical symptoms were relieved and the peritoneal effusion disappeared after single cavity drainage. 13 patients underwent multiple catheterization and drainage, and among them 1 patient underwent necrotic tissue clearance combined with choledochoscope in late stage, and 1 patient underwent surgical treatment. 18 patients were cured and discharged. The results show that the use of puncture and drainage and " step up" strategy in the treatment of severe acute pancreatitis with a large number of peripancreatic effusion is safe and effective, and it is worth popularizing in clinical practice.

关 键 词：重症急性胰腺炎 穿刺引流 治疗 

分 类 号：R658[医药卫生—外科学]