| 王国涛,刘明辉,杨谢青,刘洁玉,赵白桦.超声引导下经皮穿刺引流对重症急性胰腺炎的精准治疗[J].,2017,17(17):3302-3305 |
| 超声引导下经皮穿刺引流对重症急性胰腺炎的精准治疗 |
| Ultrasound-guided Percutaneous Catheter Drainage: A Precious Therapy in Severe Acute Pancreatitis |
| 投稿时间：2016-07-17 修订日期：2016-08-10 |
| DOI：10.13241/j.cnki.pmb.2017.17.025 |
| 中文关键词: 超声引导 经皮穿刺引流 重症急性胰腺炎 |
| 英文关键词: Ultrasound-guided Percutaneous catheter drainage Severe acute pancreatitis |
| 基金项目:湖南省自然科学基金项目（12JJ3102） |
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| 中文摘要: |
| 摘要 目的：评价超声引导下经皮穿刺置管引流(PCD)治疗重症急性胰腺炎(SAP)的安全性及临床疗效。方法：回顾性分析2011年1月-2015年12月在超声引导下经皮穿刺置管引流的273例SAP患者的临床资料，比较患者引流前后外周血白细胞(WBC)、血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平的变化。结果：273例患者中，131例患者仅经过PCD术后治愈出院；103例患者行超声引导下PCD术后全身症状得到明显改善，后期再采用经腹膜后内镜下清创术治愈出院，39例患者无好转，中转为开腹手术，PCD术的成功率为100 %。103例经内镜下清创的患者中2例死亡，39例无好转的开腹手术患者中13例死亡。患者引流后外周血白细胞(WBC)、血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均较引流前显著降低，差异有统计学意义(P<0.05)。结论：采用超声引导下的经皮穿刺置管引流治疗SAP具有定位准确、创伤小的有点，可使部分患者免于手术，或者为后续治疗创造有利条件，临床疗效显著。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the safety and effects of ultrasound-guided percutaneous catheter drainage (PCD) in the treat- ment of severe acute pancreatitis (SAP). Methods: The clinical data of 273 cases of SAP patients undergoing ultrasound-guided percuta- neous catheter drainage treatment from January 2011 to December 2015 were retrospectively analyzed. The levels of peripheral blood white blood cells (WBC), IL-6, C-reactive protein (CRP), serum TNF-α before and after the drainage were compared between two groups. Results: Ultrasound-guided percutaneous catheter drainage was performed on all 273 patients. 131 patients were cured by ultra- sound-guided percutaneous catheter drainage only and the systemic symptom of 103 patients were improved significantly and they were cured by the following-up retroperitoneal endoscopic necrosectomy. While progression of disease was found in 39 patients, they were di- rectly converted to open operation finally. All the patients were performed successfully. Two patients died after the following-up retroperitoneal endoscopic necrosectomy. 13 patients of the open operation were died. After drainaging, the levels of peripheral blood white blood cells (WBC), IL-6, C-reactive protein (CRP) and serum TNF-α dropped dramatically compared with those before the drainage(P<0.05). Conclusion: Ultrasound-guided percutaneous catheter drainage was an effective method with less trauma and precious positioning for SAP. With successful Ultrasound-guided percutaneous catheter drainage, patients could be free from operation or create an ideal surrounding for the following-up treatment. |
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