经皮穿刺腹腔置管引流治疗重症急性胰腺炎并发腹腔感染的效果分析

Effect of percutaneous puncture catheter drainage on treatment of severe acute pancreatitis with concurrent abdominal infections

目的总结经皮穿刺腹腔置管引流治疗重症急性胰腺炎（Severe Acute Pancreatitis，SAP）并发腹腔感染的效果。方法回顾性分析医院2006年1月－2012年10月收治的25例SAP并发腹腔感染患者临床资料；均采取内科综合治疗，B超或CT提示腹腔大量渗液有腹腔高压或出现继发感染的临床表现，采用经皮穿刺置腹腔引流管引流治疗，根据感染不同时期和引流液的性状选择相应的引流管。结果25例患者共经皮放置腹腔引流管55例次，引流时间10～63（20．35±5．56）d；引流期间发生引流不畅50例次，其中由于引流管堵塞25例次、扭曲18例次、滑脱7例次，均及时发现并给予相应的处理，25例患者均达到良好的引流效果，腹腔感染得到很好的控制。结论腹腔感染是SAP的严重并发症，加强对经皮穿刺腹腔引流管的护理，保持引流管的通畅，是控制感染的关键，对促进患者的早日康复至关重要。

OBJECTIVE To summarize the effect of percutaneous puncture catheter drainage on treatment of severe acute panereatitis （SAP） with concurrent abdominal infections. METHODS Totally 25 SAP patients complicated with abdominal infections, who were treated in the hospital from Jan 2006 to Oct 2012, were enrolled in the study, then the clinical data of the subjects were retrospectively analyzed, all the subjects were treated with comprehensive internal medicine therapy; the percutaneous puncture catheter drainage was performed when B- ultrasonography or CT indicated that the clinical manifestations such as the high abdominal pressure and secondary infections, and the corresponding drainage tube was chosen according to the time of occurrence of infections and the condition of drainage fluid. RESULTS Of the 25 patients, the percutaneous puncture abdominal drainage tubes have been placed for 55 case-times, the time of drainage varied between 10 and 63 days with the mean time of （20.35⊥5.56）days. Totally 50 case-times of unsuccessful drainage have occurred during the drainage, including 25 case-times due to the block of drainage tube, 18 case-times due to twist, and 7 case-times of slippage, all the cases have been discovered and given the corresponding treatment; all the 25 cases have achieved good drainage effect, and the abdominal infections have been well controlled. CONCLUSION The abdominal infection is a severe complication of the patients with SAP; it is the key of the control of infections to strengthen the nursing of pereutaneous puncture abdominal drainage tube and maintain the smooth of the drainage tube, which is crucial to the early recovery of the patients.