两种穿刺引流术治疗重症急性胰腺炎的效果  

Effect two different puncture drainage methods on treatment of patients with severe acute pancreatitis

作　　者：万秀萍[1] 翁慧斌[1] 林小花 刘媛[1] 陈大军 林海[1] 陈毓[1] WAN Xiu-ping;WENG Hui-bin;LIN Xiao-hua;LIU Yuan;CHEN Da-jun;LIN Hai;CHEN Yu(Quzhou Peopled Hospital,Quzhou Zhejiang 324000,China)

机构地区：[1]衢州市人民医院消化内科,浙江衢州324000

出　　处：《中华医院感染学杂志》2021年第1期105-109,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科研基金资助项目(2017KY699)。

摘　　要：目的探讨不同穿刺引流术对重症急性胰腺炎(Severe Acute Pancreatitis,SAP)患者的影响。方法回顾性分析衢州市人民医院2016年1月-2019年6月收治的80例SAP患者临床资料,根据穿刺引流方法分为腹膜后穿刺置管引流术(Percutaneous retroperitoneal catheter drainage,PRCD)组(n=34)和腹腔穿刺置管引流术(Abdominal paracentesis drainag,APD)组(n=46)。比较两组临床疗效、恢复时间、引流液,术前、术后1 d、3 d评估患者相关生化指标,记录两组感染性并发症发生率。结果两组患者症状体征消失时间、血清淀粉酶恢复正常时间、引流时间、住院时间对比,差异均无统计学意义,PRCD组ICU住院时间短于APD组(P<0.05);两组患者病死率、并发器官衰竭率、再手术率对比,差异均无统计学意义;两组患者引流液性状、引流量对比,差异均无统计学意义;术后1 d、3 d,两组患者CRP、PCT、SAA均呈下降趋势(P<0.05),且PRCD组各时间点指标水平均低于APD组(P<0.05);两组患者胰腺假性囊肿、胰腺脓肿、腹腔感染及总感染性并发症发生率对比,差异均无统计学意义。结论 PRCD与APD应用于SAP治疗均有效,前者在临床治疗中更有优势。OBJECTIVE To explore the influence of different puncture drainage methods on the patients with severe acute pancreatitis(SAP).METHODS The clinical data of 80 SAP patients who were treated in Quzhou People′s Hospital from Jan 2016 to Jun 2019 were retrospectively analyzed,and the enrolled patients were divided into the percutaneous retroperitoneal catheter drainage(PRCD)group with 34 cases and the abdominal paracentesis drainage(APD)group with 46 cases according to the puncture drainage methods.The clinical efficacy,recovery time and drainage fluid were compared between the two groups,the related biochemical indexes were observed before the surgery and after the surgery for 1 and 3 days,and the incidence rates of infectious complications were recorded.RESULTS There were no significant differences in the time of disappearance of symptoms and signs,time of recovery of serum amylase,drainage time and length of hospital stay between the two groups of patients.The length of ICU stay of the PRCD group was significantly shorter than that of the APD group(P<0.05).There were no significant differences in the mortality rate,incidence of concurrent organ failure and re-operation rate between the two groups of patients.There were no significant differences in the property of drainage fluid and drainage volume between the two groups of patients.The CRP,PCT and SAA of the two groups of patients showed downward trends after the surgery for 1 and 3 days(P<0.05),and the levels of the indexes of the PRCD group were significantly lower than those of the APD group at the time points(P<0.05).There were no significant differences in the incidence rates of pancreatic pseudocyst,pancreatic abscess,abdominal infection or total incidence of infectious complications between the two groups of patients.CONCLUSION Both PRCD and APD can achieve effect on treatment of SAP,and PRCD can achieve more remarkable effect on the clinical treatment.

关 键 词：重症急性胰腺炎 腹膜后穿刺置管引流术 腹腔穿刺置管引流术 

分 类 号：R657.5[医药卫生—外科学]