经皮肾镜清创引流联合血必净对急性胰腺炎合并胰腺周围脓肿患者的影响  

Effect of Percutaneous Nephroscopic Debridement and Drainage Combined with Xuebijing on Patients with Acute Pancreatitis Complicated with Peripancreatic Abscess

作　　者：张昆鹏[1] 张晓愉[1] 李少一[1] 甄品 田晓鹏[1] ZHANG Kunpeng;ZHANG Xiaoyu;LI Shaoyi;ZHEN Pin;TIAN Xiaopeng(Xingtai People's Hospital,Xingtai 054001,China;不详)

机构地区：[1]邢台市人民医院,河北邢台054001

出　　处：《中外医学研究》2024年第17期1-5,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：邢台市重点研发计划自筹项目(2022ZC1033)。

摘　　要：目的:研究经皮肾镜清创引流配合血必净对急性胰腺炎(AP)合并胰腺周围脓肿(PA)患者的影响。方法:选取2013年1月—2020年12月邢台市人民医院收治的106例AP合并PA患者作为研究对象。以电脑编号奇偶数字法随机分为联合组及常规组,各53例。所有患者均接受血必净注射治疗,常规组实施腹腔镜引流术治疗,联合组则开展经皮肾镜清创引流术治疗。比较两组临床疗效、血清炎症因子水平、T淋巴细胞亚群水平及并发症发生情况。结果:联合组治疗总有效率高于常规组,差异有统计学意义(P<0.05)。治疗后14 d,两组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)、CD8^(+)水平均低于治疗前,CD3^(+)、CD4^(+)水平均高于治疗前,且联合组CRP、TNF-α、IL-6及CD8^(+)水平低于常规组,CD3^(+)、CD4^(+)水平高于常规组,差异有统计学意义(P<0.05)。联合组并发症总发生率为5.66%,低于常规组的20.75%,差异有统计学意义(P<0.05)。结论:经皮肾镜清创引流配合血必净治疗AP合并PA患者的效果显著,且能改善血清炎症因子水平,降低并发症发生风险,改善机体免疫功能。Objective:To investigate the effect of percutaneous nephroscopic debridement and drainage combined with Xuebijing on patients with acute pancreatitis(AP)complicated with peripancreatic abscess(PA).Method:A total of 106 patients with AP complicated with PA treated in Xingtai People's Hospital from January 2013 to December 2020 were selected as the study objects.The patients were randomly divided into the combination group and the conventional group,with 53 cases in each group.All patients were treated by Xuebijing Injection,laparoscopic drainage was performed in the conventional group,and percutaneous nephroscopic debridement and drainage was performed in the combination group.The clinical efficacy,serum levels of inflammatory factors,T lymphocyte subsets and complications were compared between the two groups.Result:The total effective rate of the combination group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).At 14 d after treatment,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and CD8^(+)in both groups were lower than those before treatment,and the levels of CD3^(+)and CD4^(+)were higher than those before treatment,and the levels of CRP,TNF-α,IL-6 and CD8^(+)in the combination group were lower than those in the conventional group,and the levels of CD3^(+)and CD4^(+)were higher than those in the conventional group,the differences were statistically significant(P<0.05).The total incidence of complications in the combination group was 5.66%,which was lower than 20.75%in the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Percutaneous nephroscopic debridement and drainage combined with Xuebijing can improve the level of serum inflammatory factors,reduce the risk of complications and improve the immune function on patients with AP complicated with PA.

关 键 词：急性胰腺炎 胰腺周围脓肿 经皮肾镜 清创引流术 血必净 炎症因子 

分 类 号：R657.5[医药卫生—外科学]