PTGBD联合APD治疗重症急性胰腺炎的临床疗效  

Clinical efficacy of PTGBD combined with APD in the treatment of severe acute pancreatitis

作　　者：王强 郑传明[1] 王振杰[1] 李磊[1] 程峰[1] 陈硬 姜海[1] WANG Qiang(The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000

出　　处：《牡丹江医学院学报》2022年第1期55-58,共4页Journal of Mudanjiang Medical University

基　　金：安徽省教育厅重点项目(KJ2019A0385)。

摘　　要：目的探讨经皮经肝胆囊穿刺引流(percutaneous transhepatic gall bladder drainage,PTGBD)联合腹腔穿刺引流(abdominal puncture drainage,APD)治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的临床疗效。方法选取蚌埠医学院第一附属医院急诊外科于2018年7月至2020年7月间收治的60例SAP患者,依采用或不采用PTGBD治疗,将患者分为观察组(PTGBD+APD组)和对照组(APD组),比较两组患者经治疗后第3天、第7天的一般情况(腹痛缓解时间、胃管拔出天数、在院天数)、实验室指标[白细胞(WBC)、C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、血乳酸(Lac)],以及并发症的发生率及死亡率。结果(1)两组患者的一般情况经统计,差异均无统计学意义(P>0.05)。(2)两组患者WBC、CRP、ALT、Lac在治疗前差异均无统计学意义(P>0.05),经治疗3 d后,除WBC水平无统计学差异外(P>0.05),观察组中的CRP、Lac、ALT水平均低于对照组,差异有统计学意义(P<0.05);经治疗7 d后,观察组中WBC、CRP、Lac、ALT水平均低于对照组,差异均有统计学意义(P<0.05)。(3)观察组并发症的发生率(14.8%)低于对照组(30.3%),且死亡率(3.7%)亦低于对照组(15.1%),两组患者治疗后总体并发症的发病率及死亡率经比较,差异有统计学意义(P<0.01)。结论PTGBD联合APD治疗SAP的临床疗效更优。Objective To study clinical efficacy of percutaneous transhepatic gall bladder drainage(PTGBD)combined with abdominal puncture drainage(APD)in the treatment of severe acute pancreatitis(SAP).Methods 60 SAP patients admitted to the emergency department of the First Affiliated Hospital of Bengbu Medical College between July 2018 and July 2020 were selected.The patients were divided into observation group(PTGBD+APD group)and the control group(APD group).The general conditions of the two groups on the 3rd and 7th day after treatment(including the time to relieve abdominal pain,the number of days for removal of the gastric tube,and the number of days in the hospital),laboratory indicators[white blood cell(WBC),C Reactive protein(CRP),blood lactate(Lac),alanine aminotransferase(ALT)],the incidence of complications and mortality were compared between the two groups.Results(1)The general condition of the two patients was statistically,and the difference was not statistically significant(P>0.05).(2)There was no statistically significant difference in WBC,CRP,ALT,and Lac between the two groups before treatment(P>0.05).After 3 days of treatment,there was no statistical difference between the two groups except for the level of WBC(P>0.05).The levels of CRP,Lac,and ALT in the group were lower than those in the control group,and the difference was statistically significant(P<0.05).After 7 days of treatment,the levels of WBC,CRP,Lac,and ALT in the observation group were lower than those in the control group,and the differences were all There is statistical significance(P<0.05).(3)The overall incidence of complications in the observation group(14.8%)was lower than that of the control group(30.3%),and the mortality rate in the observation group(3.7%)was lower than that of the control group(15.1%).The overall incidence complications and death rate after treatment in the two groups were compared,and the difference was statistically significant(P<0.01).Conclusion PTGBD combined with APD has better clinical efficacy in treatment of S

关 键 词：重症急性胰腺炎 超声引导 胆囊穿刺引流 腹腔穿刺引流 临床疗效 

分 类 号：R459.7[医药卫生—急诊医学]