经皮穿刺抽液置管引流治疗重症急性胰腺炎局部并发症

Percutaneous drainage and drainage in the treatment of local complications of severe acute pancreatitis

目的探讨经皮穿刺抽液置管引流治疗重症急性胰腺炎(SAP)局部并发症的临床疗效。方法选取2012年1月～2018年7月揭阳市人民医院收治的48例SAP局部并发症患者随机分为观察组和对照组,观察组给予经皮穿刺抽液置管引流术,对照组给予常规治疗,比较两组患者住院时间、临床症状消失时间、胃肠道功能恢复时间、血淀粉酶恢复正常时间,治疗前后血钙、WBC、PCTT、BUN、SCr水平、APACHEⅡ评分、CTSI评分。结果观察组住院时间、临床症状消失时间、胃肠道功能恢复时间、血淀粉酶恢复正常时间较对照组显著缩短,差异均具有统计学意义(P <0. 05);治疗前两组患者血钙、WBC、PCT、BUN、SCr水平、APACHEⅡ评分、CTSI评分差异无统计学意义(P> 0. 05),治疗后两组患者血钙均显著上升,WBC、PCT、BUN、SCr水平、APACHEⅡ评分、CTSI评分显著下降,且治疗后观察组血钙、WBC、PCT、BUN、SCr水平、APACHEⅡ评分、CTSI评分改善更显著,差异均具有统计学意义(P <0. 05)。结论经皮穿刺抽液置管引流治疗SAP局部并发症效果显著,可改善患者临床症状,有效清除炎性胰液、坏死的组织,降低炎性反应,促进患者恢复。

Objective To investigate the clinical efficacy of percutaneous puncture drainage in the treatment of local complications of severe acute pancreatitis.Methods Forty eight patients with local complications of severe acute pancreatitis admitted to our hospital from January 2012 to July 2018 were randomly divided into observation group and control group.The observation group was treated with percutaneous puncture and drainage,while the control group was treated with routine treatment.The hospitalization time,disappearance time of clinical symptoms and recovery time of gastrointestinal function were compared between the two groups.Serum calcium,WBC,PCTT,BUN,SCr,APACHE II score and CTSI score before and after treatment.Results The hospitalization time,the disappearance time of clinical symptoms,the recovery time of gastrointestinal function and the recovery time of blood amylase in the observation group were significantly shorter than those in the control group(P<0.05).Before treatment,there was no significant difference in serum calcium,WBC,PCT,BUN,SCr,APACHE II score and CTSI score between the two groups(P>0.05).After treatment,serum calcium increased significantly in both groups,while WBC,PCT,BUN,SCr level,APACHE II score and CTSI score decreased significantly.After treatment,the levels of serum calcium,WBC,PCT,BUN,SCr,APACHE II score and CTSI score in the observation group were improved more significantly,the difference was statistically significant(P<0.05).Conclusion Percutaneous puncture,drainage and catheterization are effective in the treatment of local complications of severe acute pancreatitis.It can improve the clinical symptoms of patients,effectively remove inflammatory pancreatic juice and necrotic tissue,reduce inflammatory reaction and promote recovery of patients.