优化经皮穿刺置管引流术在重症急性胰腺炎治疗中的应用

Application of optimized percutaneous catheter drainage in the treatment of severe acute pancreatitis

目的探讨优化经皮穿刺置管引流术在合并胰腺坏死组织感染的重症急性胰腺炎(SAP)患者中的临床疗效。方法选择2017年1月~2018年6月本院普通外科收治的合并胰腺坏死组织感染的SAP患者107例,根据治疗方法分为观察组46例和对照组61例,分别采用优化经皮穿刺置管引流术和开腹胰腺坏死组织清除术。观察两组治疗前后实验室检查指标变化情况、住院时间、治疗后并发症发生率、病死率及临床疗效。结果治疗前两组白细胞计数、血淀粉酶、C-反应蛋白、血钙比较,差异无统计学意义(P>0.05)。治疗后两组白细胞计数、血淀粉酶、C-反应蛋白水平明显降低,血钙水平明显升高,且观察组白细胞计数、血淀粉酶、C-反应蛋白水平及明显低于对照组,血钙水平明显高于对照组,住院时间明显短于对照组,差异有统计学意义(P<0.05)。观察组总有效率明显高于对照组,并发症发生率及病死率明显低于对照组,差异有统计学意义(P<0.05)。结论优化经皮穿刺置管引流术治疗SAP,可明显改善患者临床症状,减轻炎性反应,缩短住院时间,降低并发症发生率和病死率,临床疗效显著。

Objective To explore the clinical effect of optimizedoptimized percutaneous catheter drainage in patients with severe acute pancreatitis(SAP)complicated with pancreatic necrotic tissue infection.Methods 107 SAP patients with pancreatic necrosis tissue infection were selected from January 2017 to June 2018 in the general surgery department of our hospital.According to the treatment methods,they were divided into observation group(46 cases)and control group(61 cases).The observation group was given the optimized percutaneous catheter drainage,and the control group was given open pancreatic necrosis tissue removal.The changes on laboratory examination indexes,hospitalization time,incidence of complications,mortality and clinical efficacy were observed before and after treatment.Results There was no significant difference in leucocyte count,blood amylase,C-reactive protein and serum calcium in the two groups before treatment(P>0.05).After treatment,the leucocyte count,serum amylase and C-reactive protein levels in the two groups decreased significantly,and serum calcium levels decreased significantly significantly increased(P<0.05).After treatment,the leucocyte count,serum amylase and C-reactive protein levels in the observation group were significantly lower than those in the control group,the serum calcium level was significantly higher than that in the control group,and the hospitalization time was significantly shorter than that in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group,and the incidence of complications and mortality were significantly lower than those of the control group(P<0.05).Conclusion Optimizing percutaneous puncture and catheter drainage for SAP can significantly improve the clinical symptoms,reduce inflammatory reaction,shorten hospitalization time,reduce the incidence of complications and mortality.The clinical effect is significant.