闭合性外伤性胰腺炎患者不同外引流方式治疗效果观察

Effects of different external drainage methods on closed traumatic pancreatitis

目的探讨闭合性外伤性胰腺炎患者不同方式外引流的临床效果。方法本院2011年6月—2013年6月诊治的闭合性外伤性胰腺炎患者50例分为腹腔镜组27例和超声定向组23例。2010年10月—2011年10月采用传统方法治疗的闭合性外伤性胰腺炎患者25例为对照组。比较3组中转开腹率、并发症发生率及住院时间。结果腹腔镜组和超声定向组中转开腹率(3.7%和4.3%)、并发症发生率(11.1%和8.6%)均明显低于对照组(16.0%和36.0%),住院时间((28.8±4.9)d和(27.9±14.3)d)短于对照组((38.3±4.8)d)(P<0.05);腹腔镜组与超声定向组比较差异均无统计学意义(P>0.05)。结论早期应用腹腔镜或超声定向方式进行穿刺外引流治疗闭合性外伤性胰腺炎可降低中转开腹率,无严重并发症。

Objective To explore the clinical effects of different external drainage methods on closed traumatic pancreatitis. Methods Fifty patients with closed traumatic pancreatitis treated with external drainage from June 2011 to June 2013 were divided into laparoscopic drainage group （n= 27） and ultrasound-guided drainage group （n= 23）. Another 25 patients received traditional external drainage from October 2010 to October 2011. The rate of conversion to laparotomy, incidence of complication and hospitalization duration were compared among three groups. Results The rates of conversion to laparotomy were 3. 7% and 4. 3%, and incidences of complications were 11. 1% and 8. 6% in laparoscopic drainage group and ultrasound-guided drainage group, lower than those in control group （16. 0% and 36.0%） （P〈0.05）. The hospitalization durations were （28.8± 4.9） and （27. 9± 14.3） days in laparoscopic drainage group and ultrasound-guided drainage group, significantly shorter than that in control group （（38.3 ± 4.8） days） （P〈 0.05）. There were no significant differences in the above indexes between laparoscopic drainage group and ultrasound- guided drainage group （P 〉0.05）. Conclusions Early application of laparoscopic drainage and ultrasound-guided drainage can reduce the rate of conversion to laparotomy for patients with closed traumatic pancreatitis, with no severe complications.