多模医学影像规划定位穿刺技术应用于重症急性胰腺炎经皮穿刺引流术中的效果分析  

Analysis of the Effect of Multimodal Medical Image Planning and Localization of Puncture Technique in Percutaneous Puncture and Drainage of Severe Acute Pancreatitis

作　　者：孙海滨[1] 付健 王冰心 陈从涛 田磊[1] 赵建辉[1] 张爱民[1] SUN Hai-bin;FU Jian;WANG Bing-xin;Chen Cong-tao;TIAN Lei;ZHAO Jian-hui;ZHANG Ai-min(The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Shijiazhuang Municipal People's Hospital,Shijiazhuang 050030,Hebei Province,China)

机构地区：[1]河北医科大学第二医院,河北石家庄050000 [2]石家庄市市人民医院,河北石家庄050030

出　　处：《中国CT和MRI杂志》2023年第12期112-115,共4页Chinese Journal of CT and MRI

基　　金：2022年河北省卫生健康委重点科技研究计划项目(20221097)。

摘　　要：目的探究多模医学影像规划定位穿刺新技术在胰腺炎经皮穿刺引流术(PCD)中的应用价值,为临床穿刺引流技术的实施提供更精确的影像引导方法。方法选取2020年1月~2022年12月我院收治的80例重症急性胰腺炎(SAP)患者进行单盲、前瞻性、随机对照研究,简单随机化分为两组,各40例。常规组采用超声实时导航定位PCD,改良组给予多模医学影像技术规划定位PCD。比较两组疗效相关指标、围术期炎性指标[C反应蛋白(CRP)、白细胞介素-10(IL-10)、白细胞介素-15(IL-15)]及1次穿刺成功率、2次穿刺成功率、技术成功率、穿刺前影像确认次数、术中穿刺操作时间、总操作时间、操作者穿刺信心(VAS评分)、穿刺路径的图像质量、患者满意度及并发症。结果两组腹痛消失、肠鸣音恢复、血淀粉酶恢复正常、排便及饮食恢复时间比较,无显著差异(P>0.05);术后1d、3d改良组血清CRP、IL-10、IL-15水平低于常规组(P>0.05);两组1次穿刺成功率、2次穿刺成功率及技术成功率比较,差异无统计学意义(P>0.05);改良组穿刺前影像确认次数少于常规组,术中穿刺操作时间、总操作时间短于常规组,VAS评分高于常规组(P<0.05);改良组穿刺路径图像质量优于常规组,满意度97.50%高于常规组77.50%(P<0.05);改良组并发症总发生率0.00%与常规组2.50%比较,差异无统计学意义(P>0.05)。结论多模医学影像规划定位穿刺新技术指导PCD治疗SAP安全性较高,能提高穿刺路径图像质量,减少影像确认次数,缩短操作时间,增强操作者穿刺信心,同时减轻机体炎症应激,提高患者满意度。Objective To investigate the value of the new technique of multimodal medical imaging planning and localization of puncture in percutaneous puncture and drainage(PCD)for pancreatitis,and to provide a more accurate imaging guidance method for the implementation of clinical puncture and drainage techniques.Methods Eighty patients with severe acute pancreatitis(SAP)admitted to our hospital from January 2020 to December 2022 were selected for a single-blind,prospective,randomized controlled study,and simply randomized into two groups of 40 patients each.In the conventional group,realtime ultrasound navigation was used to locate the PCD,and in the modified group,multimodal medical imaging techniques were given to plan and locate the PCD.the two groups were compared in terms of efficacy-related indicators,perioperative inflammatory indicators[C-reactive protein(CRP),interleukin-10(IL-10),interleukin-15(IL-15)]and the success rate of 1 puncture,2 punctures,technical success rate,pre-puncture image confirmation number of times,intraoperative puncture operation time,total operation time,operator confidence in puncture(VAS score),image quality of the puncture route,patient satisfaction and complications.Results There was no significant difference in the disappearance of abdominal pain,recovery of bowel sounds,normalization of blood amylase,recovery time of bowel movement and diet between the two groups(P>0.05);serum CRP,IL-10 and IL-15 levels in the modified group were lower than those in the conventional group 1d and 3d postoperatively(P>0.05);there was no statistically significant difference in the success rate of 1 puncture,2 punctures and technical success rate between the two groups(P>0.05);the number of image confirmations before puncture was less in the modified group than in the conventional group,the intraoperative puncture operation time and total operation time were shorter than in the conventional group,and the VAS score was higher than in the conventional group(P<0.05);the image quality of the puncture route w

关 键 词：重症胰腺炎 穿刺引流术 穿刺新技术 医学影像 患者满意度 安全性 

分 类 号：R657.51[医药卫生—外科学]