腹腔穿刺引流用于急性胰腺炎并液体积聚观察

摘要

目的：评估早于经皮穿刺置管引流（ PCD）进行腹腔穿刺引流（ APD）的有效性，以代替单独经皮穿刺置管引流（ PCD-alone），作为升阶梯治疗的新的第2步治疗方法。方法：以2009年6月到2011年6月入院的102例急性胰腺炎患者为研究对象，根据是否行APD将患者分为APD＋PCD组53例和单独PCD组49例。通过回顾性分析，比较其术后死亡率、反复发作急性胰腺炎和慢性胰腺炎的发生率、器官衰竭、远期干预等。结果：APD＋PCD组死亡率3.77％，单独PCD组死亡率8.16％，APD＋PCD组显著低于单独PCD组（ P＜0.05）。经2年随访，APD＋PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为7.84％、5.88％，单独PCD组反复发作急性胰腺炎及慢性胰腺炎发生率分别为14.29％、8.16％，APD＋PCD组显著低于单独PCD组（P＜0.05）。 APD＋PCD组较单独PCD组器官衰竭数少，从发病到远期干预的时间明显延迟，住院费用较低。结论：早于PCD进行APD有益于患者，且方法简单实用，值得临床推广。%Objective:To evaluate the efficacy of abdominal paracentesis drainage ( APD) ahead of percutaneous catheter drainage ( PCD) in the replacement of PCD-alone treatment as the new second step of a step-up approach for acute pancreatitis ( AP).Methods:102 consecutive AP patients were admitted from June 2009 to June 2011.According to whether or not APD was applied , they were divided into two groups: 53 Patients in APD +PCD group , 49 ones in PCD-alone group.Observed parameters mainly included mortality , the incidence of recurrent AP or chronic pancreatitis ( CP) , organ failures and the indexes of further interventions.Results: The mortality rate in the APD +PCD group was 3.77% while the PCD-alone group was 8.16%;the APD+PCD group showed significantly lower mortality rate than the PCD-alone group(P<0.05).After 2-year follow-up, the incidence of recurrent AP and CP in the APD +PCD group was 7.84% and 5.88% while the PCD-alone group was 14.29%and 8.16%, respectively;the APD +PCD group showed significantly lower recurrent incidence than the PCD-alone group(P<0.05).Compared with the PCD-alone group, the number of organs failed was decreased , the interval from the onset of AP to further interventions was remarkably delayed , and the cost of hospitalization significantly reduced in the APD +PCD group.Conclusion:APD ahead of PCD is beneficial to AP patients , which is simple and worthy of clinical application.