【摘要】：目的探討經(jīng)皮穿刺置管引流應(yīng)用于重癥急性胰腺炎繼發(fā)腹腔感染的臨床療效性和安全性。方法對(duì)2010年6月-2013年9月確診為重癥急性胰腺炎合并繼發(fā)腹腔感染患者76例,隨機(jī)分為觀察組和對(duì)照組,各38例,對(duì)照組給予常規(guī)保守治療,觀察組給予影像引導(dǎo)下的經(jīng)皮穿刺置管引流,觀察兩組患者臨床療效性和術(shù)后恢復(fù)等。結(jié)果治療前,兩組患者血白細(xì)胞及血、尿淀粉酶差異無統(tǒng)計(jì)學(xué)意義,治療后,均明顯改善,較治療前差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組血白細(xì)胞差異無統(tǒng)計(jì)學(xué)意義,而血、尿淀粉酶差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組總有效率為92.1%、病死率為5.3%,對(duì)照組總有效率為78.9%、病死率為15.8%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組患者癥狀體征消失的時(shí)間、住院天數(shù)及飲食恢復(fù)時(shí)間均短于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論影像引導(dǎo)下經(jīng)皮穿刺置管引流是治療重癥急性胰腺炎繼發(fā)腹腔感染安全可行的方法,能夠通過微創(chuàng)的手術(shù)方法達(dá)到全面探查和充分引流的治療目的,有效提高患者臨床療效,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the clinical efficacy and safety of percutaneous catheter drainage for abdominal infection secondary to severe acute pancreatitis. Methods from June 2010 to September 2013, 76 patients with severe acute pancreatitis complicated with secondary abdominal infection were randomly divided into observation group (n = 38) and control group (n = 38). The patients in the observation group were treated with percutaneous puncture and drainage under the guidance of image. The clinical curative effect and postoperative recovery were observed in the two groups. Results before treatment, there was no significant difference in blood leukocyte, blood and urine amylase between the two groups. After treatment, the difference was significantly improved (P0.05), but the difference between the two groups was not statistically significant after treatment, but there was no significant difference between the two groups after treatment. The difference of urine amylase was statistically significant (P0.05), the total effective rate of observation group was 92.1, the mortality rate was 5.3, the total effective rate of control group was 78.9 and the mortality rate was 15.8.The difference was statistically significant (P0.05); the time of disappearance of symptoms and signs in observation group was significant (P0.05). Days of hospitalization and diet recovery time were shorter than the control group, the differences were statistically significant (P0.05). Conclusion Image guided percutaneous catheterization and drainage is a safe and feasible method for the treatment of abdominal infection secondary to severe acute pancreatitis. It is worth popularizing and applying to improve the clinical effect of patients.
【作者單位】： 重慶三峽中心醫(yī)院消化科;
【基金】：重慶市科技局基金資助項(xiàng)目(Nb2012-2-6-1)
【分類號(hào)】：R576

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