经皮腹腔穿刺引流治疗重症急性胰腺炎早期胰周或腹腔积液的疗效观察

目的:评价经皮腹腔穿刺引流治疗重症急性胰腺炎早期胰周或腹腔积液的临床效果及安全性。方法:应用超声或CT引导行经皮腹腔穿刺引流治疗重症急性胰腺炎早期胰周或腹腔积液患者37例，比较穿刺前和穿刺后第3天患者的临床症状及各项临床和检验指标，并观察并发症发生情况。结果:患者穿刺后第3天临床症状明显缓解，临床和生化指标及腹腔内压、急性生理与慢性健康状况评分、多器官功能障碍评分均较治疗前改善（P<0.05～P<0.01）。其中3例（8.1%）患者发生穿刺相关性损伤，2例（5.4%）引流过程中发生导管阻塞，3例（8.1%）发生导管易位，1例（2.7%）发生导管脱落，所有患者均无肠管及腹腔脏器损伤等严重并发症。结论:对于伴有腹腔或胰周积液的早期重症急性胰腺炎患者，经皮腹腔穿刺引流术可改善临床症状，缓解腹腔内压力并改善临床和检验指标。

Clinical effect of the percutaneous catheter drainage in the treatment of the peripancreatic or peritoneal effusion in the early phase of severe acute pancreatitis

Objective:To observe the clinical efficacy and safety of the percutaneous catheter drainage( PCD) in the treatment of the peripancreatic or peritoneal effusion in the early phase of severe acute pancreatitis. Methods:The peripancreatic or peritoneal effusion in the early phase of severe acute pancreatitis in 37 patients were treated with PCD guided by ultrasound or CT. The clinical symptoms, clinical and laboratory indicators between before puncture and after 3 days of puncture,and the postoperative complications in all cases were compared. Results:Compared before treatment,the clinical symptoms,and the scores of clinical and biochemical indexes,intra-abdominal pressure,acute physiology and chronic health conditions and multiple organ dysfunction syndrome were significantly improved after 3 days of puncture(P<0. 05 to P <0. 01). The puncture injury in 3 cases(8. 1%),drainage catheter obstruction in 2 cases (5. 4%),catheter translocation in 3 cases(8. 1%) and catheter off in 1 case(2. 7%) were found. No serious complications(including bowel and abdominal visceral injury ) in all cases were identified. Conclusions:The treatment of the peripancreatic or peritoneal effusion in the early phase of severe acute pancreatitis with PCD can improve the clinical symptoms,clinical and laboratory indicators, and relieve the intra-abdominal pressure of patients.