超声引导穿刺置管持续充分引流改善伴胰腺周围渗出急性胰腺炎患者肺功能的机制

发布时间：2018-11-28 19:34

【摘要】：目的探讨超声引导穿刺置管引流(PCD)持续充分引流改善伴有胰腺周围渗出的急性胰腺炎(SAP)患者肺功能的机制。方法 25例对照组患者接受常规ICU治疗,26例试验组患者接受常规ICU治疗+PCD持续充分引流治疗。检测治疗前及治疗48 h后腹腔内压力(IAP)、血淀粉酶(AMS)、肿瘤坏死因子(TNF)-α、气道平台压(Pplat)、氧合指数(PO_2/FiO_2)、动脉血氧分压(PaO_2)和动脉血二氧化碳分压(PaCO_2)指标变化。结果对照组治疗前后除Pplat和PaCO_2其他指标均有统计学差异(P0.05);试验组治疗前后全部指标均有统计学差异(P0.05);两组治疗前,各指标无统计学差异(P0.05),治疗后除PaO_2和PaCO_2,其他指标均有统计学差异(P0.05)。结论 PCD持续充分引流能够明显改善伴有胰腺周围渗出SAP患者的肺功能,可能对急性呼吸窘迫综合征(ARDS)有预防和治疗作用。
[Abstract]:Objective to investigate the mechanism of continuous and adequate drainage of (PCD) under ultrasound guidance in patients with acute pancreatitis (SAP) with peripancreatic exudation. Methods 25 patients in the control group were treated with conventional ICU, and 26 patients in the test group were treated with continuous adequate drainage of PCD with routine ICU. Before and 48 hours after treatment, intraperitoneal pressure (IAP), serum amylase (AMS), tumor necrosis factor (TNF)-伪), airway plateau pressure (Pplat),) oxygenation index (PO_2/FiO_2) were measured. Changes of arterial partial pressure of oxygen (PaO_2) and arterial partial pressure of carbon dioxide (PaCO_2). Results there were significant differences in all the indexes except Pplat and PaCO_2 before and after treatment in the control group (P0.05), and all the indexes in the test group were statistically different before and after treatment (P0.05). Before treatment, there was no statistical difference between the two groups (P0.05), except PaO_2 and PaCO_2, after treatment there was statistical difference (P0.05). Conclusion continuous and adequate drainage of PCD can significantly improve pulmonary function in patients with SAP with peripancreatic exudation, and may have preventive and therapeutic effects on (ARDS) in patients with acute respiratory distress syndrome.
【作者单位】：吉林省人民医院肝胆胰外科;
【基金】：吉林省卫生计生委项目(No.2015SZC10)
【分类号】：R576

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