主动经皮穿刺引流治疗重症急性胰腺炎并发急性坏死物积聚的疗效分析  

Analysis of curative effect of active percutaneous puncture drainage in the treatment of severe acute pancreatitis complicated with acute necrotic accumulation

作　　者：党军强 杨雁灵 汪庆强 尚琳 朱磊 项红军 Dang Junqiang;Yang Yanling;Wang Qingqiang;Shang Lin;Zhu Lei;Xiang Hongjun(Department of Hepatobiliary Surgery,Daxing Hospital of Xi'an,Xi'an Shaanxi Province 710003,China;Department of Hepatobiliary Pancreatic and Splenic Surgery,Xijing Hospital of Air Force Military Medical University University,Xi'an Shaanxi Province 710003,China)

机构地区：[1]西安大兴医院肝胆外科,西安710003 [2]西京医院肝胆胰脾外科,西安710003

出　　处：《中华普外科手术学杂志（电子版）》2024年第6期671-674,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的分析主动经皮穿刺置管引流(PCD)法用于治疗重症急性胰腺炎(SAP)并发急性坏死物积聚(ANC)患者的临床疗效。方法回顾性分析2020年10月至2021年10月接受主动PCD治疗的23例和2018年9月至2020年9月接受标准PCD治疗的47例患者的临床资料。采用SPSS 23.0统计软件对数据进行分析。正态分布的计量资料以(χ±s)表示,采用独立样本t检验;分类资料分析采用χ^(2)检验;Fisher确切概率法对小样本的分类变量进行对比分析。P<0.05表示差异有统计学意义。结果两组患者在人口统计学数据、胰腺炎的病因和疾病严重程度、PCD适应证及PCD相关并发症方面比较差异无统计学意义(P>0.05);标准PCD组患者住院时间更长,有更多患者需ICU监护以及ICU监护时间更长(P<0.05);两组患者术后持续器官衰竭逆转数(78.6%vs.56.0%,P=0.190),死亡率及手术率方面差异无统计学意义(P>0.05);主动PCD组更多患者升级了引流管(P=0.030),置入了更多引流管(P=0.048),引流管尺寸更大(P<0.01)。主动PCD组APACHE评分减少幅度更高(P<0.01),引流管更通畅(P<0.01),能够更早地拔除引流管(P=0.012)。结论主动PCD法是ANC的有效引流方法,可有效治疗ANC。Objective To analyze the clinical efficacy of active percutaneous catheter drainage(PCD)in the treatment of severe acute pancreatitis(SAP)complicated by acute necrotic accumulation(ANC).Methods Clinical data of 23 patients who received active PCD from October 2020 to October 2021 and 47 patients who received standard PCD from September 2018 to September 2020 were retrospectively analyzed.SPSS 23.0 statistical software was used to analyze the data.The measurement data of normal distribution are represented by(χ±s),and independent sample t test is adopted.X test was used to analyze the classified data.Fisher exact probability method is used for comparative analysis of small sample categorical variables.P<0.05 indicated that the difference was statistically significant.ResultsThere were no significant differences in demographic data,etiology and severity of pancreatitis,indications of PCD and complications related to PCD between the two groups(P>0.05).Patients in standard PCD group had longer hospital stay,more patients required ICU monitoring and longer ICU monitoring(P<0.05).There was no significant difference in the number of patients with persistent organ failure reversal(78.6%us.56.0%,P=0.190),mortality and operation rate between the two groups(P>0.05).More patients in the active PCD group had upgraded drainage tubes(P=0.030),more drainage tubes were inserted(P=0.048),and the drainage tube size was larger(P<0.01).In the active PCD group,the APACHE score decreased more(P<0.01),the drainage tube was more smooth(P<0.01),and the drainage tube could be removed earlier(P=0.012).Conclusion Active PCD is an effective drainage method for ANC and can effectively treat ANC.

关 键 词：重症急性胰腺炎 急性坏死物积聚 经皮穿刺置管引流 

分 类 号：R657.5[医药卫生—外科学]