摘要
目的探讨重症急性胰腺炎合并局部积液应用经皮穿刺置管引流后的临床效果及预后分析。方法回顾性分析我院2015年1月至2017年6月收治的24例SAP合并局部积液并行PCD治疗的患者临床资料,分析早期症状缓解情况、穿刺并发症及感染发生情况,以及穿刺治疗的效果。结果 24例患者中,穿刺后66.7%(16/24)的患者早期症状获得缓解;并发腹腔内出血2例;穿刺后继发感染8例,5例为混合性感染,分离培养细菌12株。最终,17例患者经穿刺获得治愈,治愈率为70.8%(17/24);3例穿刺治疗后好转,但后期因各种原因自动出院;穿刺有效率为83.3%(20/24)。4例穿刺治疗无效,其中2例转外院继续治疗,2例死亡。结论 PCD是治疗重症急性胰腺炎合并局部积液的有效方法,安全、微创,但PCD可诱发腹膜后感染,应严格掌握穿刺指征。
Objective To investigate the clinical effect and prognosis of severe acute pancreatitis combined with local effusion after percutaneous catheter drainage. Methods This was a retrospective analysis of 24 patients with SAP from January 2015 to June 2017 in our department. All patients were complicated with local effusion and treated with PCD. The earlier symptom remission, complications, infection and the effect of puncture treatment were analyzed. Results In the patients, 66. 7% （ 16/24） of the patients was remission in earlier stage after the puncture ;2 cases had intraperitoneal hemorrhage. After the puncture, secondary infection occurred in 8 cases and 5 cases were mixed infection. 12 strains were isolated and cultured. Finally, 17 patients were cured by puncturing, the cure rate was 70. 8% （17/24） ; 3 cases improved after the puncture treatment, but discharged automatically for various reasons. The effective rate of the puncture was 83.3% （20/24）. 4 cases were ineffective, in the patients,2 cases were transferred to the external hospital, 2 eases died. Conclusion PCD is an effective method for the treatment of severe acute pancreatitis complicated with local effusion. It is safe and minimally invasive, but PCD can induce retroperitoneal infection, and the indications of the puncture should be strictly controlled.
作者
姜大同
项和平
李贺
高明
尹纯林
葛魏巍
王召华
JIANG Da-tong;XIANG He-ping;LI He(The Second Hospital of Anhui Medical University, Hefei 230601, China)
出处
《肝胆外科杂志》
2018年第2期102-105,共4页
Journal of Hepatobiliary Surgery
关键词
急性胰腺炎
重症
经皮穿刺置管引流
效果
acute pancreatitis
severe
percutaneous catheter drainage
effect
