介入超声穿刺引流治疗胰周脓肿

目的 探讨采用介入超声技术行胰周脓肿引流的可行性.方法 回顾性分析2006年7月至2009年11月成都军区总医院收治的36例胰周脓肿患者的临床资料.结合胰周脓肿的部位、范围、形状等因素,确定穿刺点位置.根据穿刺点与靶区的空间对应关系,计算导管针进入的角度和方向,在超声引导下置入引流管引流.结果 36例患者均成功接受穿刺引流,33例治愈,治愈率为92%,平均治愈时间37 d.3例因穿刺引流效果欠佳改行开腹手术引流.3例患者并发肠外瘘,经非手术治疗痊愈.所有患者随访3～48个月,无脓肿残留或复发.2例并发1型糖尿病,1例消化不良,2例合并胆囊结石,经对症治疗痊愈.27例患者体质量较术前增加.结论 介入超声穿刺引流治疗胰周脓肿切实可行.

Ultrasound-guided percutaneous drainage for peripancreatic abscess

Objective To investigate the feasibility of ultrasound-guided percutaneous drainage for the treatment of peripancreatic abscess. Methods The clinical data of 36 patients with peripancreatic abscess who were admitted to the General Hospital of the Chengdu Military Command were retrospectively analyzed. All the puncture sites were designed according to the region, range and shape of the abscess, and then the angle and the direction of the needle penetration were determined according to the spatial relationship between the puncture site and the abscess. Finally, the drainage tubes were placed under the guidance of the ultrasound. Results The technique was successfully performed on all the patients, and 33 patients were cured with the cure rate of 92%.The mean healing time was 37 days. Three patients were converted to laparotomy because of the unsatisfied therapeutic effects. Enterocutaneous fistula was detected in 3 patients after the surgery and they were cured after receiving nonoperative management. All patients were followed up for 3-48 months, and neither residual abscess nor recurrence was detected. Two patients were complicated with type one diabetes, one with dyspepsia, two with gallstone, and they were cured by symptomatic treatment. The body weights of 27 patients were increased compared to those before the operation. Conclusion Ultrasound-guided percutaneous drainage is effective for the treatment of peripancreatic abscess.