论文部分内容阅读
目的:探讨经皮穿刺置管引流术(PCD)治疗急性重症胰腺炎(SAP)胰腺周围组织坏死感染的临床效果。方法:回顾性分析对113例手术治疗的SAP合并胰腺周围组织坏死感染(胰腺坏死范围<30%)患者资料,其中采用PCD治疗54例(PCD组),采取直接开腹手术引流治疗的有59例(开腹组),对比两组患者的相关临床指标。结果:两组治疗前白细胞、血淀粉酶、尿淀粉酶、血糖值、血钙值差异均无统计学意义(均P>0.05),治疗后两组以上实验室指标均较各自治疗前明显改善(均P<0.05)。治疗后比较,PCD组血淀粉酶、尿淀粉酶、血糖值均明显低于开腹组患者(均P<0.05);PCD组住院时间、住院费用、死亡或放弃治疗率均明显的低于开腹组(均P<0.05);两组治疗有效率(79.6%vs.81.4%)、引流液体细菌培养结果差异均无统计学意义(均P>0.05)。结论:PCD治疗SAP合并胰腺周围组织坏死感染(胰腺坏死范围<30%)的效果确切,同时具有缩短住院时间、减少住院费用的优势。
Objective: To investigate the clinical effect of percutaneous catheter drainage (PCD) in the treatment of pancreatic necrosis of the pancreas in patients with acute severe pancreatitis (SAP). Methods: A retrospective analysis of 113 cases of surgical treatment of SAP with pancreatic necrosis of the surrounding tissue (pancreatic necrosis <30%) patients, including the use of PCD treatment of 54 cases (PCD group), to take direct laparotomy drainage of 59 Cases (open group), comparing the two groups of patients with clinical indicators. Results: There was no significant difference in leucocyte, blood amylase, urine amylase, blood glucose and serum calcium between the two groups before treatment (all P> 0.05). After treatment, the indexes of two groups of laboratory above were significantly improved (All P <0.05). After treatment, the serum amylase, urinary amylase and blood glucose in PCD group were significantly lower than those in open group (all P <0.05). The PCD inpatient time, hospitalization cost, death or abandonment rate were significantly lower than those in open group (P <0.05). The effective rates of both groups were 79.6% vs.81.4%, there was no significant difference between the two groups (all P> 0.05). Conclusions: The PCD treatment of SAP combined with necrotic tissue around the pancreas (pancreatic necrosis <30%) is effective and has the advantage of shortening hospital stay and reducing hospitalization costs.