经皮穿刺置管引流术治疗重症急性胰腺炎合并胰腺坏死感染的临床效果及对炎性因子和并发症的影响  

Clinical Effect of Percutaneous Catheter Drainage on Severe Acute Pancreatitis Complicated with Pancreatic Necrosis Infection and Its Impact on Inflammatory Factors and Complications

作　　者：韩佳 韦丹 韦彪 HAN Jia;WEI Dan;WEI Biao(Department of General Surgery,the First People's Hospital of Hechi City,Hechi,Guangxi Zhuang Autonomous Region 546300,China)

机构地区：[1]河池市第一人民医院普外科,广西壮族自治区河池546300

出　　处：《解放军医药杂志》2020年第9期58-61,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：广西壮族自治区卫生和计划生育委员会科研课题(Z20170178)。

摘　　要：目的研究经皮穿刺置管引流术(PCD)治疗重症急性胰腺炎合并胰腺坏死感染的临床效果及对炎性因子和并发症的影响。方法选取2014年2月—2018年5月132例重症急性胰腺炎合并胰腺坏死感染患者。根据治疗方式将其分为PCD组63例及开腹手术组69例。比较2组临床疗效、治疗前后炎性因子、实验室指标、手术效果和并发症情况。结果2组临床治疗有效率和再次手术率比较差异无统计学意义(P>0.05)。治疗后,2组的降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、尿淀粉酶、血淀粉酶以及血糖水平较治疗前均明显降低,且PCD组明显低于开腹手术组(P<0.05)。治疗后,2组的白细胞计数较治疗前均明显下降(P<0.05),但2组间比较差异无统计学意义(P>0.05)。PCD组住院时间、病死率以及术后并发症发生率均较对照组低(P<0.05)。结论PCD治疗对重症急性胰腺炎合并胰腺坏死感染患者有显著的临床疗效,可改善患者术后炎性因子水平,降低并发症。Objective To explore the clinical effect of percutaneous catheter drainage(PCD)in the treatment of severe acute pancreatitis(SAP)with pancreatic necrosis infection and its impact on inflammatory factors and complications.Methods A total of 132 patients with SAP and pancreatic necrosis infection were selected from February 2014 to May 2018.According to different treatment methods,they were divided into PCD group(n=63)and laparotomy group(n=69).The clinical efficacy,inflammatory factors before and after treatment,laboratory indicators,surgical effects and complications were compared between the two groups.Results There was no significant difference in clinical treatment efficiency and reoperation rate between the two groups(P>0.05).After treatment,the levels of procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),urinary amylase,blood amylase and blood glucose were significantly lower than those before treatment,and the indexes was significantly lower in PCD group than in the laparotomy group(P<0.05).After treatment,the white blood cell counts of the two groups were significantly lower than those before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).The length of hospital stay,mortality and postoperative complications in the PCD group were lower than those in the control group(P<0.05).Conclusion PCD treatment has a significant clinical effect on patients with SAP and pancreatic necrosis infection,which can improve the level of postoperative inflammatory factors and reduce complications.

关 键 词：重症急性胰腺炎 经皮穿刺置管引流术 肿瘤坏死因子-α 白介素-8 淀粉酶 并发症 

分 类 号：R657.5[医药卫生—外科学]