B超引导下穿刺置管引流治疗创伤性胰腺假性囊肿

The treatment of traumatic pseudocyst of pancreas with ultrasound-guided percutaneous drainage

目的探讨B超引导下穿刺置管引流对创伤性胰腺假性囊肿（TPP）的治疗效果。方法回顾性分析45例TPP患者的临床资料及B超引导下穿刺置管引流的方法及效果。结果全组45例中腹部外伤40例，医源性创伤5例。TPP在伤后或术后6～60d（平均31d）发现。TPP最长径5～13[平均（9．2±2．3）cm]。囊液淀粉酶均〉1000U／L。45例均行B超引导T穿刺置管引流治疗。引流时间7～86d，（平均37d）。引流液体20～500mL／d。41例（91．1％）引流治疗治愈。4例（8．9％）引流量每天维持在100～200mL，2周后行ERCP检查提示主胰管断裂，改用手术治疗治愈。45例均随访3～12个月（平均8个月），无不适症状。B超、CT检查无囊肿复发。结论B超引导下穿刺置管引流是处理TPP的一种简单、有效的方法，大部分患者可获得理想的效果。

Objective To investigate the effect of ultrasound-guided percutaneous drainage （ UGPD ） for patients with traumatic pseudocyst of pancreas （ TPP ）. Methods Retrospective analysis of the clinic feature, treatments and the effect of 45 cases of TPP treated in our hospital in recent six years were made. Results Of the 45 cases,40 cases were caused by abdominal trauma,5 cases were caused by injury in the operation of spleneetomy for patients with portal hypertension. The TPPs were found from 6 days to 60 days （ average ： 31 days ） after the injury of pancreas. The diameters of TPP were from 5 to 13 cm with average of （ 9.2±2.3 ） cm. All the 45 patients underwent UGPH. The drainage time was 7 to 86 days with average time of 37 days. The drainage fluids were 20 to 500 ml every day. Forty-one （91. 1% ） patients were cured by UGPH; and four （ 8.9 % ） patients were changed to perform operation because of ERCP showing breaking of the pancreatic duct after two weeks drainage. All patients were recovered with no complication and no recurrence for 3 months to one year follow-up. Condusions UGPD was effective method for patients with TPP, and most of the patients can get a good prognosis.