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目的:研究超声引导下经皮穿刺置管引流治疗重症急性胰腺炎的临床疗效。方法:选择2016年1月-2016年12月华中科技大学同济医学院附属武汉中心医院重症医学科收治的SAP患者60例,随机分为常规治疗组(观察组)和超声穿刺治疗组,每组30例。对照组患者为采取保守治疗,观察组在上述保守治疗措施的基础上实施超声引导下经皮穿刺置管引流。比较两组治疗前后血淀粉酶、脂肪酶和血浆炎性介质(TNF-α、IL-6、IL-8)水平变化;比较两组机械通气时间、ICU住院时间及28天死亡率。结果:治疗72h后,两组患者血淀粉酶、脂肪酶及血浆炎性介质水平均下降(P<0.05);但观察组患者血淀粉酶、脂肪酶及血浆炎性介质水平在相同时间点明显低于对照组。观察组患者机械通气时间、ICU住院时间、死亡率明显低于对照组,临床转归优于对照组(P<0.05)。结论:超声引导下经皮穿刺置管引流具有多种优势,对重症急性胰腺炎具有确切疗效,具有较高的临床应用价值。
Objective: To study the clinical effect of ultrasound guided percutaneous catheter drainage in the treatment of severe acute pancreatitis. Methods: Sixty patients with SAP who were admitted to Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2016 to December 2016 were randomly divided into routine treatment group (observation group) and ultrasound puncture treatment group 30 cases. The control group of patients to take conservative treatment, the observation group in the above conservative treatment based on the implementation of ultrasound-guided percutaneous catheter drainage. The levels of serum amylase, lipase and inflammatory mediators (TNF-α, IL-6 and IL-8) in the two groups were compared before and after treatment. The mechanical ventilation time, hospital stay time and 28-day mortality were compared between the two groups. Results: After 72 hours of treatment, serum amylase, lipase and plasma inflammatory mediators decreased in both groups (P <0.05). However, serum amylase, lipase and plasma inflammatory mediators in the observation group were significantly higher at the same time point Lower than the control group. The observation group patients with mechanical ventilation time, ICU hospital stay, mortality was significantly lower than the control group, the clinical outcome was better than the control group (P <0.05). Conclusion: Ultrasound guided percutaneous catheter drainage has many advantages, the exact effect of severe acute pancreatitis, has a high clinical value.