早于经皮穿刺置管引流进行腹腔穿刺引流有益于合并液体积聚的急性.DOC

2016-06-19 魏编辑加工完成 2016-10-12 董 2016-10-26 董返魏，魏送贾 腹腔穿刺引流用于急性胰腺炎并液体积聚观察 高 勇1,2，钟 刚1 ，李建军1，钟利春1，沈 艳1，郑晓博2 （1.成都市天府新区人民医院消化内科，四川 成都 610213； 2.成都军区总医院全军普通外科中心，四川 成都 610083） [摘要]目的：评估早于经皮穿刺置管引流（PCD)进行腹腔穿刺引流（APD)的有效性，以代替单独经皮穿刺置管引流（PCD-alone），作为升阶梯治疗的新的第2步治疗方法。方法：以2009年6月到2011年6月入院的102例急性胰腺炎的患者为研究对象，根据是否行APD将患者分为APD+PCD组53例，单独PCD组49例。通过回顾性分析，比较其术后死亡率、反复发作急性胰腺炎和慢性胰腺炎的发生率、器官衰竭、远期干预等。结果：APD+PCD组死亡率3.77%，单独PCD组死亡率8.16%，APD+PCD组显著低于单独PCD组（P＜0.05）。经2年的随访，APD+PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为7.84%、5.88%，单独PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为14.29%、8.16%），APD+PCD组显著低于单独PCD组（P＜0.05）。APD+PCD组较单独PCD组器官衰竭数少，从发病到远期干预的时间明显延迟，住院费用较低。结论：早于PCD进行APD有益于患者，且方法简单实用，值得临床推广使用。 [关键词]腹腔穿刺引流；经皮穿刺置管引流；急性胰腺炎；液体积聚；升阶梯治疗方法 [中图分类号]R657.5+1 [文献标识码]A DOI:10.11851/j.issn.1673-1557.2016.06.0 Abdominal Paracentesis Drainage Acute Pancreatitis Patients with fluid collection GAO Yong1,2,ZHONG Gang1,LI Jianjun2,ZHONG Lichun 1,SHEN Yan1 ,ZHENG Xiaobo2 （1 Department of Gastroenterology, Peoples Hospital of Chengdu Tianfu Area, Chengdu, Sichuan 610213,China;2 Department of General Surgery, General Hospital of Chengdu Military Command, Chengdu, Sichuan 610083,China） [Abstract] Objective: To evaluate the efficacy of abdominal paracentesis drainage (APD) ahead of percutaneous catheter drainage (PCD) in treatment of acute pancreatitis(AP). Methods: 102 consecutive AP patients were admitted from June 2009 to June 2011. According to whether or not APD was applied, they were divided into two groups: 53 Patients in APD+PCD group, 49 ones in PCD-alone group. Observed parameters mainly included mortality, the incidence of recurrent AP or chronic pancreatitis (CP), organ failures and the indexes of further interventions. Results: The mortality rate in the APD+PCD group was 3.77% while the PCD-alone group was 8.16%;the APD+PCD group showed significantly lower mortality rate than the PCD-alone group（P＜0.05).After 2-year follow-up, the incidence of recurrent AP and CP in the APD+PCD group was 7.84% and 5.88% while the PCD-alone gro