超声引导下引流急性胰腺炎腹腔积液的置管技巧及疗效探讨

发布时间：2018-03-20 18:58

本文选题：超声引导　切入点：经皮穿刺置管引流　出处：《中国超声医学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下经皮穿刺置管引流术治疗急性胰腺炎(AP)所致腹腔不同部位积液的穿刺技巧及疗效。方法选取160例我院临床确诊为AP的住院患者,其中胰周积液60例,肝肾间隙积液27例,脾肾间隙积液38例,肠间积液35例。用置管成功率、并发症发生率及引流通畅率评价超声引导下穿刺置管术治疗不同部位腹腔积液的疗效。结果在胰周积液穿刺中,一步法与置换法的置管成功率及并发症发生率的差异具有统计学意义(P0.05),其差异在肝肾、脾肾及肠间隙积液中没有统计学意义(P0.05);在胰周、肝肾、脾肾积液中选择不同管径引流管的引流通畅率及并发症发生率差异具有统计学意义(P0.05),在肠间隙积液的引流中差异没有统计学意义(P0.05);置管后的冲洗干预方式在不同部位积液的引流通畅率及并发症发生率差异有统计学意义(P0.05)。结论合理选择超声引导下穿刺置管引流术的术式、引流管的管径及置管后的冲洗干预方式对AP不同部位腹腔积液的引流疗效有重要意义。
[Abstract]:Objective to investigate the puncture technique and efficacy of ultrasound-guided percutaneous catheter drainage in the treatment of peritoneal effusion caused by acute pancreatitis (AP). Methods 160 patients with AP were selected, including 60 patients with peripancreatic effusion. There were 27 cases of hepatic and renal interstitial effusion, 38 cases of splenorenal space effusion and 35 cases of intestinal effusion. The incidence of complications and the rate of drainage patency were used to evaluate the effect of ultrasound-guided catheterization in the treatment of celiac effusion in different parts. The difference of success rate and complication rate between one-step method and replacement method was statistically significant (P 0.05), and there was no significant difference in liver and kidney, spleen kidney and intestinal interspace effusion, while in peripancreatic, liver and kidney, there was no significant difference between one step method and replacement method. The difference of drainage patency rate and complication rate of different diameter drainage tube in spleen and kidney effusion was statistically significant (P 0.05), but there was no significant difference in intestinal space effusion drainage (P 0.05). There were significant differences in the drainage patency rate and complication rate of local effusion (P 0.05). Conclusion the operative method of puncture and drainage under the guidance of ultrasound should be reasonably selected, and there is no significant difference in the incidence of complications between the two groups. The diameter of drainage tube and the way of washing intervention after insertion are of great significance to the drainage effect of peritoneal effusion in different parts of AP.
【作者单位】：甘肃省人民医院超声医学科;
【基金】：甘肃省科技支撑计划项目(No.1504FKCA061)
【分类号】：R445.1;R576

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