胰动脉置管持续区域灌注治疗重症急性胰腺炎

Continous Regional Intra-arterial Infusion for the Treatment of Severe A cute Pancreatitis

目的 :评价经胰血管留置导管持续区域灌注生长抑素和抗生素治疗重症急性胰腺炎 ( SAP)的疗效。方法 :将 2 9例SAP患者分为区域灌注组 ( 13例 )和常规给药组 ( 16例 )。区域灌注组经股动脉超选择插管至胰腺坏死的供血动脉留置导管 ,用微泵持续 2 4 h灌注生长抑素及抗生素 ,症状体征消失后拔管。常规给药组用静脉输注药物 ,药物用量及剂量完全同区域灌注组。结果 :灌注组治疗后 4 8h腹部体征明显改善 ,腹痛减轻 ,7～ 12天症状全部消失 ,病情无复发 ,疗程平均 2 0天 ,均痊愈出院。常规给药组治疗后 5～ 7天见腹部体征改善 ,病情有反复 ,疗程 4 5天～ 4个月 ,平均 5 7天。常规给药组出现严重并发症 13例次 ,死亡4例。结论 :经胰血管置管持续区域灌注生长抑素及抗生素治疗 SAP疗效好 ,病程短 ,并发症少 。

Objective:To evaluate the therapeutic effic acy of con tinous regional intra arterial infusion (CRI) of sandostatin and antibiotics in patients of severe acute pancreatitis (SAP). Methods:Twenty nine ca se s of SAP patients were randomly divided into two groups. Group of CRI, 13 cases and control group, 16 cases. Seldinger′s method was used in brief, placing a ca theter in the pancreatic regional artery such as gastropyloric artery, irrigatin g the inflamed area of the pancreas, and infusing sandostatin and antibiotics to control inflammation and prevent secondary infection by continuous pumping for 24 h. Results:Abdominal sings and pain were apparently relieved afte r 24 h of treatment, disappeared in 7 12 days. Twelve cases were cured. Clinical manifestations in control group lasted much longer compared with CRI group, aft er 5 7 days of the treatment, abdominal signs began subsiding. Conclusion :continous regional intra arterial infusion for the treatment of severe a cu te pancreatitis can prevent the development of pancreatic infection and big cut the course of treatment.