CT引导下穿刺引流与开腹引流术治疗重症急性胰腺炎感染继发胰腺周围脓肿的效果比较

发布时间：2018-05-06 21:11

本文选题：CT引导 + 重症急性胰腺炎　；参考：《中华医院感染学杂志》2017年06期

【摘要】：目的探讨CT引导下穿刺引流与开腹引流术治疗重症急性胰腺炎感染继发胰腺周围脓肿的效果比较。方法选取2008年1月-2016年6月于医院收治的重症急性胰腺炎(SAP)感染继发胰腺周围脓肿患者39例,根据治疗方法不同将其分为观察组20例与对照组19例,采取开腹引流术对对照组进行治疗,采取CT引导下穿刺引流术对观察组进行治疗;治疗后对两组临床疗效及相关临床指标进行比较。结果与对照组比较,观察组患者术后残余脓肿率、体温恢复正常时间、住院时间及住院费用均明显降低,差异有统计学意义(P0.05)。与治疗前相比,两组患者治疗后其CRP及PCT水平均显著降低(P0.05),且观察组较对照组降低程度更显著(P0.05);在治疗总有效率方面,观察组85.0%与对照组78.9%比较相当,差异无统计学意义;在并发症发生率方面,观察组20.0%与对照组73.7%比较明显降低,差异有统计学意义(P0.05)。结论对重症急性胰腺炎感染继发胰腺周围脓肿的患者给予CT引导下穿刺引流术治疗具有良好的治疗效果,同时能缩短恢复时间与住院时间,降低并发症发生率及住院费用,具有较高安全性,值得临床进一步推广应用。
[Abstract]:Objective to compare the effect of CT guided puncture drainage and open drainage in the treatment of peripancreatic abscess secondary to severe acute pancreatitis infection. Methods from January 2008 to June 2016, 39 patients with secondary pancreatic abscess caused by severe acute pancreatitis (SAP) infection were divided into observation group (n = 20) and control group (n = 19) according to different treatment methods. The control group was treated by laparotomy and drainage, and the observation group was treated by CT guided puncture and drainage. After the treatment, the clinical efficacy and related clinical indexes were compared between the two groups. Results compared with the control group, the rate of residual abscess, the time of body temperature returning to normal, the time of hospitalization and the cost of hospitalization in the observation group were significantly lower than those in the control group (P 0.05). Compared with before treatment, the levels of CRP and PCT in the two groups were significantly lower than those in the control group, and the degree of decrease in the observation group was more significant than that in the control group, and the total effective rate of the observation group was 85.0% compared with 78.9% of the control group, the difference was not statistically significant. The incidence of complications in the observation group (20.0%) was significantly lower than that in the control group (73.7%), and the difference was statistically significant (P 0.05). Conclusion CT-guided puncture and drainage in patients with severe acute pancreatitis infection secondary to peripancreatic abscess has a good therapeutic effect. It can also shorten the recovery time and hospital stay, reduce the incidence of complications and hospital expenses. It is safe and worthy of further clinical application.
【作者单位】：杭州市萧山区第一人民医院介入科;浙江大学医学院附属邵逸夫医院放射科;杭州市萧山区第一人民医院胃肠外科;浙江省肿瘤医院介入科;杭州市萧山区第一人民医院肿瘤内科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2011KYA135)
【分类号】：R576

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