CT引导下穿刺引流与开腹引流术治疗重症急性胰腺炎感染继发胰腺周围脓肿的效果比较

Effects of CT-guided puncture drainage and open drainage on treatment of severe acute pancreatitis patients with secondary peripancreatic abscess:a comparative study

目的探讨CT引导下穿刺引流与开腹引流术治疗重症急性胰腺炎感染继发胰腺周围脓肿的效果比较。方法选取2008年1月-2016年6月于医院收治的重症急性胰腺炎(SAP)感染继发胰腺周围脓肿患者39例,根据治疗方法不同将其分为观察组20例与对照组19例,采取开腹引流术对对照组进行治疗,采取CT引导下穿刺引流术对观察组进行治疗;治疗后对两组临床疗效及相关临床指标进行比较。结果与对照组比较,观察组患者术后残余脓肿率、体温恢复正常时间、住院时间及住院费用均明显降低,差异有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后其CRP及PCT水平均显著降低(P<0.05),且观察组较对照组降低程度更显著(P<0.05);在治疗总有效率方面,观察组85.0%与对照组78.9%比较相当,差异无统计学意义;在并发症发生率方面,观察组20.0%与对照组73.7%比较明显降低,差异有统计学意义(P<0.05)。结论对重症急性胰腺炎感染继发胰腺周围脓肿的患者给予CT引导下穿刺引流术治疗具有良好的治疗效果,同时能缩短恢复时间与住院时间,降低并发症发生率及住院费用,具有较高安全性,值得临床进一步推广应用。

OBJECTIVE To compare the effects of CT-guided puncture drainage and open drainage on treatment of severe acute pancreatitis（SAP）patients with secondary peripancreatic abscess.METHODS A total of 39 SAP patients with secondary peripancreatic abscess who were treated in hospitals from Jan 2008 to Jun 2016 were enrolled in the study and divided into the observation group with 20 cases and the control group with 19 cases according to the treatment method.The control group was treated with open drainage,while the observation group was treated with CT-guided puncture drainage.The clinical effects and related clinical indexes were observed and compared between the two groups after the treatment.RESULTS The rate of postoperative residual abscess of the observation group was significantly lower than that of the control group;the time of recovery of body temperature and length of hospital stay of the observation group were significantly shorter than those of the control group;the hospitalization cost of the observation group was significantly less than that of the control group（P〈0.05）.The levels of CRP and PCT of the two groups of patients were reduced more significantly after the treatment than before the treatment（P〈0.05）,which were reduced more significantly in the observation group than in the control group（P〈0.05）.The total effective rate of treatment was 85.0% in the observation group,78.9% in the control group,and there was no significant difference.The incidence of complications was 20.0% in the observation group,significantly lower than 73.7%in the control group（P〈0.05）.CONCLUSION The CT-guide puncture drainage can achieve significant therapeutic effect on the SAP patients with secondary peripancreatic abscess,shorten the time of recovery and length of hospital stay,and reduce the incidence of complications,as well as the hospitalization cost,with the safety high,and it is worthy to be promoted in the hospital.