CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究(附43例报道)

Clinical Study on CT Guided Puncture to The Diagnosis and Treatment of Local Complications of Severe Acute Pancreatitis(Report of 43 Cases)

目的探讨CT引导下经皮穿刺抽液检查和(或)置管外引流在重症急性胰腺炎(severe acute pancre-atitis,SAP)局部并发症中的诊治价值。方法对我院2003年3月至2008年2月期间收治43例合并胰腺坏死、胰周积液、假性胰腺囊肿及脓肿并发症的SAP患者进行了CT引导下经皮穿刺抽液检查和(或)置管外引流,观察其疗效。结果43例SAP患者共穿刺64例次,穿刺成功率为100%。其中24例行诊断性穿刺抽液检查,诊断符合率为100%。41例(95%)置管引流48例次,1例直接行开腹手术,1例自动出院。腹胀缓解率为93%(40/43),中转开腹手术率为37%(16/43),置管外引流有效率为61%(25/41)。结论采用CT引导下穿刺抽液检查和(或)置管外引流对部分SAP患者局部并发症的诊治效果较好。

Objective To explore the value of CT guided percutaneous puncture, aspiration and drainage on diagnosis and treatment of local complications of severe acute pancreatitis （SAP）. Methods Forty-three cases of SAP combined with pancreatic necrosis, peripancreatic hydrops, pseudocyst and abscess were analyzed, all of them underwent CT guided percuta-neous puncture, aspiration and drainage. Results The punctures were performed on 43 SAP patients for sixty-four times, the success rate was 100%, and in 24 cases of them puncture were peHormed for diagnosis, the positive rate of fluid absorption by puncture was 100%. Forty-one of 43 cases （95%） received puncture and tube drainage, open operation was performed in one patient, one patient was automatically discharged. The remission rate of abdominal distension was 93% （40/43） and 16 of 43 cases （37%） were turned to open operation. The effective rate of drainage was 61% （25/41）. Conclusion The puncture, aspiration and drainage guided by CT is an effective method in diagnosis and treatment of local complications in part of SAP cases.