超声引导经皮腹膜后穿刺置管引流前腹腔穿刺引流治疗重症急性胰腺炎的临床价值

doi:10.3969/j.issn.1005-6483.2019.05.017

摘要/Abstract

摘要： 目的:探讨超声引导经皮腹膜后穿刺置管引流前腹腔穿刺引流治疗重症急性胰腺炎的临床效果。方法:重症急性胰腺炎病人98例，采用随机数字表将其分为两组，对照组49例，采用超声引导经皮腹膜后穿刺置管引流术，试验组49例，先行腹腔穿刺引流治疗，而后超声引导经皮腹膜后穿刺置管引流。比较两组病人术后外周血白细胞水平恢复正常所需时间、器官衰竭率、住院时间、治疗前和治疗后（术后7天）膀胱压、APACHEⅡ评分、血栓素A2（TXA2）含量、前列环素（PGI2）含量和临床疗效。结果:试验组和对照组术后术后外周血WBC恢复正常所需时间分别为（22.31±1.96）天和（26.84±2.07）天，器官衰竭率分别为34.69%和57.14%，差异有统计学意义（P<0.05）。治疗后试验组和对照组APACHEⅡ评分分别为（6.94±3.22）和（11.91±3.86），TXA2分别为（146.53±20.61）ng/ml和（218.21±17.94）ng/ml，PGI2分别为（173.54±15.38）ng/ml和（146.47±16.12）ng/ml，两组比较差异有统计学意义（P<0.05）；两组病人临床疗效比较，差异有统计学意义（P<0.05）。结论:超声引导经皮腹膜后穿刺置管引流前腹腔穿刺引流治疗重症急性胰腺炎，能够显著改善预后，减少器官系统的衰竭，提高临床疗效。

关键词: 经皮腹膜后穿刺置管引流, 重症急性胰腺炎, 腹腔穿刺引流, 超声引导

Abstract: Objective:To investigate the clinical effect and prognosis with ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis.Methods:98 cases of surgical treatment of severe acute pancreatitis patients，using random numbers table patients were divided into control group （after ultrasoundguided percutaneous peritoneal drainage tube） and the experimental group （first abdominal puncture drainage treatment，and then after ultrasoundguided percutaneous peritoneal drainage tube），49 cases in each group.Compared two groups of patients with postoperative peripheral blood leukocyte levels back to normal time，organ failure rate，the length of time needed for the statistical differences，compared two groups of patients before and after the treatment （7 d） postoperative bladder pressure，APACHEⅡ score，content of TXA2 and PGI2 levels of statistical significance，compared two groups of patients after treatment clinical curative effect of statistical significance.Result:The recovery time of WBC in the experimental group [（22.31±1.96）d] was lower than that in the control group [（26.84±2.07）d]，and the organ failure rate in the experimental group （34.69%） was lower than that in the control group （57.14%），the differences were statistically significant（P<0.05）.After treatment，treatment group patients with APACHEⅡ score（6.94±3.22） was significantly lower than the control group patients（11.91±3.86）（P<0.05）；After treatment，TXA2[（146.53±20.61）ng/ml] in the experimental group was significantly lower than that in the control group [（218.21±17.94）ng/ml]（P<0.05），and PGI2[（173.54±15.38）ng/ml] in the experimental group was significantly higher than that in the control group[（146.47±16.12）ng/ml].The recovery rate in the experimental group was significantly higher than that in the control group（P<0.05）.Conclusion:Ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis can significantly improve the prognosis of patients，reduce organ system failure，and improve clinical efficacy.

Key words: percutaneous retroperitoneal catheterization and drainage, severe acute pancreatitis, peritoneal puncture drainage, ultrasonic

罗文婷, 谭碧君, 甘田, 熊智魁, 周利华. 超声引导经皮腹膜后穿刺置管引流前腹腔穿刺引流治疗重症急性胰腺炎的临床价值[J]. 临床外科杂志, 2019, 27(5): 412-415.

参考文献

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

本文评价

推荐阅读 10

[1]	金鑫;周鹏;赵文超;等. 肾脏混合性上皮间质肿瘤一例[J]. 临床外科杂志, 2016, 24(10): 785 .
[2]	黄国全;吴泉峰;孙建华等 . 术前奥沙利铂联合替吉奥化疗对进展期胃癌手术治疗的影响分析 [J]. 临床外科杂志, 2016, 24(6): 430 .
[3]	李红;王娜娜;陈庆勇等 . 支气管脂肪瘤一例 [J]. 临床外科杂志, 2016, 24(6): 424 .
[4]	宁雅婵;汪忠镐;王春梅等. 颈动脉支架术后过度灌注致脑出血一例[J]. 临床外科杂志, 2016, 24(8): 620 .
[5]	寇晓梅柯永莉张晨芳等. 应用邻近扩张皮瓣修复T4期局部晚期乳腺癌术中大面积软组织缺损的临床研究[J]. 临床外科杂志, 2016, 24(9): 675 .
[6]	陶继祥;刘国辉;夏天等. 皮肤牵张器在创面缺损修复中的应用[J]. 临床外科杂志, 2017, 25(10): 777 -780 .
[7]	任朋张烨陶建新沈仁辉王彤. 吲哚菁绿显像对减少腹腔镜结直肠癌根治术后吻合口漏的作用[J]. 临床外科杂志, 2018, 26(10): 754 -756 .
[8]	周霄楠;周建华;李勇等. 动脉瘤破裂腔内修复术后主动脉消化道瘘一例[J]. 临床外科杂志, 2018, 26(2): 99 .
[9]	吴同岭;侯伟东;唐向阳. 可调节外固定支架结合有限内固定治疗C型桡骨远端骨折的临床观察[J]. 临床外科杂志, 2018, 26(3): 228 .
[10]	谭锋维薛奇牟巨伟高禹舜毛友生王大力赵峻李宁王镇高树庚赫捷. 从最新指南解读食管胃交界部腺癌的外科治疗[J]. 临床外科杂志, 2018, 26(9): 641 -643 .