早期腹腔穿刺引流对重症急性胰腺炎的临床效果分析

Clinical effect of early abdominal puncture and drainage on Severe Acute Pancreatitis

目的 探讨早期腹腔穿刺引流对重症急性胰腺炎(severe acute pancreatitis, SAP)的临床效果。方法 回顾性分析2019年1月至2022年1月湖南省人民医院急诊一部ICU收治的82例SAP临床资料,42例患者行早期(2周内)腹腔穿刺引流分为引流组,40例患者行保守治疗分为对照组,比较腹腔穿刺引流后2组患者炎症指标(白细胞、降钙素原、C反应蛋白)、并发症发生率(SIRS持续时间、胰腺假性囊肿、胰腺感染、腹腔间隔综合征、转外科手术)、ICU住院时间、总住院时间、病死率等。结果 引流组的炎性指标、SIRS持续时间、胰腺假性囊肿率、腹腔间隔综合征发生率、转外科手术发生率、ICU住院时间、总住院时间、病死率方面均低于对照组(P<0.05),2组患者在发生胰腺感染方面无明显差异(P>0.05)。结论 早期腹腔穿刺引流可明显降低SAP患者炎性指标,减少SAP患者并发症的发生、缩短ICU及总住院时间、降低病死率,并且不增加患者胰腺炎感染的风险,值得临床推广。

Objective To explore the clinical effect of early abdominal puncture and drainage on Severe Acute Pancreatitis(SAP).Methods The clinical data of 82 patients with SAP who were admitted to the ICU of the first Department of emergency of Hunan Provincial People’s Hospital from January 2019 to January 2022 were retrospectively analyzed, 42 patients underwent early(within 2 weeks) paracentesis and drainage divided into drainage group, and 40 patients underwent conservative treatment divided into control group to compare the inflammatory indicators(white blood cells, procalcitonin, C-reactive protein) between the 2 groups after paracentesis and drainage Incidence of complications(duration of SIRS, pancreatic pseudocyst, pancreatic infection, abdominal compartment syndrome, and conversion to surgery), length of ICU stay, total hospital stay, and case fatality. Results The drainage group had lower inflammatory indicators, SIRS duration, pancreatic pseudocyst rate, abdominal compartment syndrome rate, incidence of conversion surgery, ICU stay, total hospital stay, and case fatality than the control group(P<0.05), and there was no significant difference between the 2 groups in the occurrence of pancreatic infection(P>0.05).Conclusions Early abdominal puncture and drainage can significantly reduce the inflammatory indicators, reduce the occurrence of complications, shorten the ICU and total hospital stay, reduce the mortality rate of patients with SAP, and do not increase the risk of pancreatitis infection in patients, which deserves clinical promotion.