超声引导下联合置管治疗急性胆源性胰腺炎的探讨

发布时间：2018-12-10 18:31

【摘要】：目的探讨超声引导联合置管治疗急性胆源性胰腺炎(ABP)的临床价值。方法 121例经实验室及临床证实为ABP患者分为3组,A组28例,未行超声引导下置管组;B组30例,超声引导下腹腔穿刺置管组;C组63例,超声引导下腹腔及胆囊或胆管穿刺联合置管应用组。B、C组统称为置管组,统计并分析各组并发症发生率及死亡率。结果 3组间在合并胰漏、切口感染及腹腔脓肿方面有显著统计学差异(P=0.032,P=0.004,P=0.018),与A组相比,B组在切口感染率方面显著降低(P=0.013),C组在合并胰漏、切口感染及腹腔脓肿方面均显著降低(P=0.045,P=0.008,P=0.001)。置管组(B+C组)与未置管组(A组)相比,在切口感染及腹腔脓肿合并率方面均显著降低,差异有统计学意义(P=0.001,P=0.027)。结论超声引导下腹腔穿刺置管,尤其是腹腔与胆囊或胆管穿刺联合置管的应用可显著降低ABP的并发症,是一种安全、有效的微创治疗方法。
[Abstract]:Objective to evaluate the clinical value of ultrasound-guided combined catheterization in the treatment of acute biliary pancreatitis (ABP). Methods 121 patients with ABP confirmed by laboratory and clinic were divided into three groups: group A (n = 28), group B (n = 30), group B ( Group C (n = 63) was treated with ultrasound guided abdominal cavity and cholecyst or bile duct puncture combined with catheterization, and group B was called catheterization group. The incidence and mortality of complications in each group were statistically analyzed. Results there were significant differences among the three groups in complicated pancreatic leakage, incisional infection and abdominal abscess (P0. 032, P0. 004, P0. 018). Compared with group A, the infection rate of incision in group B was significantly lower (P0. 013). In group C, pancreatic leakage, incisional infection and abdominal abscess were significantly decreased (P0. 045, P0. 008, P0. 001). The incidence of incision infection and abdominal abscess in the (B C group was significantly lower than that in the non-catheterized group (P0. 001 and 0. 027). Conclusion Ultrasound-guided intraperitoneal catheterization, especially in combination with cholecyst or bile duct puncture, can significantly reduce the complications of ABP and is a safe and effective minimally invasive treatment.
【作者单位】：甘肃省人民医院超声科;宁夏工人疗养院超声科;
【分类号】：R576;R445.1

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