早期行腹膜后穿刺引流术对重症急性胰腺炎疗效的影响  

Effect of Early Retroperitoneal Percutaneous Catheter Drainage on the Treatment of Severe Acute Pancreatitis

作　　者：林婵婵 张葵玲[1] 陈小令 苏雅青 朱晓东 陈新琦 LIN Chanchan;ZHANG Kuiling;CHEN Xiaoling;SU Yaqing;ZHU Xiaodong;CHEN Xinqi(Department of Gastroenterology,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院消化内科,福建泉州362000

出　　处：《中国卫生标准管理》2023年第20期82-85,共4页China Health Standard Management

摘　　要：目的探讨早期行腹膜后穿刺引流术(percutaneous catheter drainage,PCD)对重症急性胰腺炎(severe acute pancreatitis,SAP)疗效的影响。方法回顾性研究2014年1月—2021年12月在福建医科大学附属泉州第一医院住院治疗的74例SAP患者的临床资料。根据入院后7 d内是否行PCD治疗,将纳入患者分为≤7 d PCD组(48例)和>7 d PCD组(26例)。比较两组腹痛腹胀缓解时间、开放饮食时间、住院时间、外科进阶率、病死/不愈率、新发器官衰竭发生率、并发脓毒症概率以及穿刺引流相关并发症发生率等指标。结果≤7 d PCD组的患者腹胀、腹痛症状及体征缓解时间、开放饮食时间、住院时间均明显短于>7 d PCD组(P<0.05)。≤7 d PCD组新发脏器功能衰竭发生率低于>7 d PCD组,差异有统计学意义(P<0.05);两组脓毒症发生率比较,差异无统计学意义(P>0.05)。两组的外科进阶率、病死/不愈率及穿刺引流相关并发症发生率均差异无统计学意义(P>0.05)。结论入院后7 d内完成PCD,虽不能降低SAP患者的外科进阶率和病死/不愈率,但可以明显缩短大部分患者临床症状缓解时间、开放饮食所需时间和住院时间,减轻患者痛苦,降低新发器官衰竭发生率,且7 d内完成PCD并不增加导管相关并发症的发生率。本研究结果为后期制定重症急性胰腺炎腹膜后穿刺术时机的选择提供了借鉴内容。Objective To investigate the effect of early retroperitoneal percutaneous catheter drainage(PCD)on the treatment of severe acute pancreatitis(SAP).Methods Clinical data of 74 patients with SAP who were hospitalized in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2014 to December 2021 were retrospectively studied.According to whether the patients received PCD treatment within 7 d after admission,the included patients were divided into≤7 d PCD group(48 cases)and>7 d PCD group(26 cases).The time of relief of abdominal pain and distension,the time of open diet,the time of hospital stay,the rate of surgical progress,the rate of death/non-recovery,the incidence of new organ failure,the probability of sepsis and the incidence of complications related to puncture and drainage were compared between the two groups.Results The relief time of abdominal pain and distension,the time required for open diet and the length of hospital stay in the≤7 d PCD group were significantly shorter than those in the>7 d PCD group(P<0.05).The incidence of new organ failure in≤7 d PCD group was lower than that in>7 d PCD group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of sepsis between the two groups(P>0.05).There were no significant differences in the surgical progression rate and the incidence of complications related to puncture and drainage in the death/unhealing rate between the two groups(P>0.05).Conclusion Completion of PCD within 7 days after admission can not reduce the rate of surgical progression and death/unhealing in patients with SAP,but can significantly shorten the time of clinical symptom relief,the time required for open diet and the length of hospital stay in most patients,reduce the pain of patients,reduce the incidence of new organ failure.Completion of PCD within 7 days did not increase the incidence of catheter-related complications.The results of this study provide reference for the selection of the timing of retrop

关 键 词：重症急性胰腺炎 腹膜后穿刺引流术 胰周液体积聚 器官衰竭 脓毒症 导管相关并发症 

分 类 号：R747[医药卫生—神经病学与精神病学]