超声介入在重症急性胰腺炎伴腹腔积液患者中的应用

Application of ultrasound intervention in treatment of severe acute pancreatitis in patient with seroperitoneum

目的探讨超声介入在重症急性胰腺炎并发腹腔积液患者中的应用价值.方法超声介入置管引流临床确诊的45例重症急性胰腺炎患者,对比观察前后全身炎症反应指标及器官功能评价,并评价超声介入置管引流对胰腺炎并发腹腔积液的处理效果.结果超声介入置管后第1、2周超敏C-反应蛋白(hs-CRP)的水平,降钙素原水平(PCT),白介素6(IL-6),腹腔内压(IAP)较治疗前明显下降(均P<0.05).缓解腹痛、腹胀症状,缩短肠道功能恢复时间,SIRS持续时间约1周左右,MODS的发生率28.9%(13/45),死亡1例,占2.22%(1/45).对重症急性胰腺炎合并残余感染病灶可减轻症状.结论超声介入置管引流治疗SAP,能明显减轻胰腺周围炎症反应,促进早期肠道功能恢复,控制病情进展.

Objective To investigate the application value'of ultrasound-guided percutaneous cathater drainage for severe a-cute pancreatitis with seroperitoneum.Methods The clinical data of 45 SAP patients complicated-with seroperitoneum undergoing ultrasound-guided PCD during January 2019 to December 2020 were retrospectively analyzed,and make assessment of inflammatory response marker and organ function.Results All the patients have undergone PCD successfully.Compared with the preoperation,the CRP,PCT,IL-6,IAP decreased signficantly.And the duration of abdomenpain,abdomen distention and resume of bowel movement function were shorter,The duration of SIRS was about 1 week.The incidence of MODS was 2&9%(13/45),and there was 1 death(2.22%,1/45).Symptoms can be alleviated for SAP with local infected necrosis complication.Conclusion Ultrasound intervention for SAP with seroperitoneum can significantly reduce the inflammation around the pancreas,promote the recovery of early bowel movement function,and control the progress of SAP.