区域动脉灌注治疗重症急性胰腺炎20例

Local arterial infusion therapy for 20 cases of acute necrotizing pancreatitis

目的评价经动脉插管灌注奥曲肽和抗生素治疗急性坏死性胰腺炎的疗效。方法20例急性坏死性胰腺炎患者，根据CT检查结果置导管于病变部位的供血动脉，导管置于胃十二指肠动脉10例，于腹腔动脉10例，经导管24h持续灌注奥曲肽和抗生素6—14d。结果20例中19例经局部动脉给药痊愈，1例药物灌注后病情缓解3个月后，行假性胰腺囊肿手术引流。结论区域动脉灌注治疗的急性重症胰腺炎，疗效肯定，并发症少。

Objective To evaluate the intra - arterial infusion of pancreatic enzyme inhibitor and antibiotics in the treatment of acute necrotizing pancreatitis （ANP）. Methods Twenty patients with ANP were treated with arterial infusion by placing a cather in the celiac artery, spleen artery or gastroduodenal artery. Octreotide and antibiotics was used continuously for 6 to 14 days. According to the site of the inflamnation on the CT scan,the top of the catheter was set in the celiac in 10 cases and gastroduodenal artery in 10 cases. Results The mortality rate in this study was 0 and no procedure related complication was observed. Nineteen of 20 patients had good effect, without severe complication. In one case, drainage of parapancreatic abscess was performed after local arterial infusion（LAI） for pancreatic pseudcyst. Conclusion LAI therapy of octreotide and antibiotics for ANP offers good therapeutic effect.