主动经皮穿刺置管引流感染性坏死组织对重症急性胰腺炎病人转归的影响

Effect of active percutaneous catheter drainage of infectious necrotizing tissue on outcomes of patients with severe acute pancreatitis

目的探讨主动经皮穿刺置管引流(percutaneous catheter drainage,PCD)用于治疗感染坏死性胰腺炎(infected pancreatic necrosis,IPN)的临床疗效。方法2019年7月~2020年10月间,我院收治的行主动PCD治疗的IPN病人21例(主动PCD组),2017年1月~2019年3月接受升阶梯治疗的病人53例(升阶梯组)。总结治疗效果,随访并评估存活病人的生存质量。结果主动PCD组病人置入了更多引流管,有更多的病人在治疗中增加了引流管,而且置入的引流管尺寸明显大于升阶梯组,差异有统计学意义(P<0.05)。升阶梯组病人住院时间更长,需重症护理病人数更多,引流管持续引流的时间更长,差异有统计学意义(P<0.05)。两组死亡率和手术率比较,差异无统计学意义。结论主动PCD治疗可缩短住院时间,可有效治疗IPN。

Objective To investigate the clinical efficacy of proactive percutaneous catheter drainage(PCD)in the treatment of infected pancreatic necrosis(IPN).Methods The clinical data of 21 IPN patients treated with proactive PCD in our hospital from July 2019 to October 2020 were retrospectively analyzed and compared with 53 patients treated with step-up approach from January 2017 Results In the proactive PCD group,more drainage tubes were inserted,more patients increased drainage tubes in the treatment,and the size of the inserted drainage tubes was significantly larger than that in the step-up approach group(P<0.05).The hospitalization time of patients in the step-up approach group was longer,the number of patients in intensive care unit(ICU)was larger,and the duration of continuous drainage of drainage tube was longer(P<0.05).There was no significant difference in mortality and surgical rate between the two groups.Conclusion Proactive PCD treatment can not only shorten the hospitalization time,but also effectively treat IPN.