超声引导经皮置管引流治疗小儿早期症状性胰腺假性囊肿

Ultrasound-Guided Percutaneous External Drainage Therapy for Children with Early Symptomatic Pancreatic Pseudocyst

目的探讨超声引导下经皮穿刺置管引流治疗小儿早期胰腺假性囊肿（PPC）的临床价值。方法 1993年1月-2010年1月徐州医学院附属医院15例小儿早期症状性PPC,通过超声检查确定PPC的位置、穿刺的部位、角度及导管置入深度后,在局麻下经皮穿刺囊肿,置入8-10 F引流管行持续外引流,并对引流后的情况进行随访观察。结果 15例患儿均一次穿刺置管成功,穿刺径路包括腹前壁10例,侧腹壁5例。囊壁活检均未发现肿瘤细胞。无并发症发生。术后1周复查血淀粉酶均正常。15例患儿均得到随访,随访4-13个月,平均12个月。其中12例囊肿消失后拔管,随访期间未复发。3例外引流迁延不愈,6周后行手术治疗。结论小儿早期症状性PPC确诊后,采用超声引导经皮置管引流术治疗创伤小,安全有效,并发症少,是一种疗效显著的微创治疗方法。

Objective To explore the clinical value of ultrasound-guided percutaneous external drainage therapy for children with early symptomatic pancreatic pseudocyst（PPC）.Methods Fifteen cases diagnosed as early symptomatic PPC from Jan.1993 to Jan.2010 in the Affiliated Hospital of Xuzhou Medical College were retrospectively analyzed.All cases were measured the point,the angle and the depth of puncture under ultrasound.Guidance,pseudocyst puncture and catheterization of external draining were made and followed up.Results The successful rate of percutaneous catheter external drainage once time was 100%.Puncture path included frontal in 10 cases,lateral in 5 cases,and there was no incidence of complications.All 15 cases were followed up,follow-up time was 4-13 months（average 12 months）.Follo-wing disappearance of PPC,catheters were extracted in 12 cases,3 cases had surgerical operations after drainaing 6 weeks.Conclusions The technique of percutaneous catheter external draininag guided by ultrasound is a therapy with less trauma,better efficacy and fewer complications,and can provide a clinical effective minimally invasive treatment.