超声引导下经皮穿刺置管引流方法治疗重症急性胰腺炎的临床效果

Clinical effect of ultrasound-guided percutaneous catheter drainage in the treatment of severe acute pancreatitis

目的探讨超声引导下经皮穿刺置管引流方法治疗重症急性胰腺炎(SAP)的临床效果。方法选取2015年6月~2016年6月来我院进行就诊的120例SAP患者,按照随机数字表法分为对照组和观察组,各60例。对照组采用常规治疗方法进行治疗,观察组在常规治疗的基础上采用超声引导下经皮穿刺置管引流进行治疗,比较两组患者的治疗效果和康复情况、相关实验室观察指标的变化情况和并发症的发生情况。结果观察组的积液消失时间、血清CRP、体温和血淀粉酶恢复正常及住院时间均短于对照组(P<0.01),观察组中转手术率为3.33%,明显低于对照组的18.33%(P<0.01)。治疗前,观察组患者血淀粉酶、尿淀粉酶及白细胞水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者血淀粉酶、尿淀粉酶及白细胞水平均明显下降,血钙明显上升,与对照组比较,差异有统计学意义(P<0.01)。观察组多器官功能障碍综合征(MODS)、急性呼吸窘迫综合征(ARDS)、败血症发生率均低于对照组,差异有统计学意义(P<0.05)。结论超声引导下经皮穿刺置管引流术具有微创、方便、安全有效等优点,不仅能减少患者的痛苦,同时又可减少术后并发症的发生,促进患者康复,缩短患者的住院时间。

Objective To investigate the clinical effect of ultrasound-guided percutaneous catheter drainage in the treatment of severe acute pancreatitis.Methods Altogether 120 patients with severe acute pancreatitis（SAP） who were treated in our hospital from June 2015 to June 2016 were selected and divided into control group and observation group according to random number table mothod.Patients in the control group were treated with conventional therapy,while patients in the observation group were treated with ultrasound-guided percutaneous catheter drainage based on conventional therapy.The treatment effect,rehabilitation and change of related laboratory indexes,occurrence of complications of two groups were statistically analyzed and compared.Results The effusion disappearance time,serum C reactive protein（CRP）,body temperature and blood amylase recovery time and hospitalization time of the observation group was shorter than that of the control group（P〈0.01）;the rate of converting operation of the observation group was3.33%,significantly lower than that of the control group（18.33%）（P 0.01）.Before treatment,there was no significant difference in the levels of serum amylase,urine amylase and white blood cell between two groups（P〈0.05）;after treatment,blood amylase,urine amylase and white blood cells of the observation group was significantly decreased and serum calcium of the observation group was increased significantly in comparison with that of the control group,with statistically significant difference（P〈0.01）.The incidence of multiple organ dysfunction syndrome（MODS）,acute respiratory distress syndrome（ARDS） and septicemia of the observation group was lower than that of the control group,with statistically significant difference between two groups（P 0.05）.Conclusion Ultrasound-guided percutaneous catheter drainage is featured with minimal invasion,convenience,safety and effective advantages,which not only can reduce the pain of patients,but also reduce the incidence of postoperative complications,promote the rehabilitation of patients and shorten the hospitalization time.