超声引导经皮置管引流在重症急性胰腺炎治疗中的应用价值

目的探讨超声引导经皮置管引流在重症急性胰腺炎治疗中的应用价值。方法自2002-01~2004-06对9例重症急性胰腺炎患者,采用了包括超声引导经皮置管引流在内的多种非手术治疗手段。其中,对6例腹腔渗液较多者,实施超声引导下经皮穿刺置管引流和腹腔灌洗;对4例合并胰腺周围积液并感染者,实施超声引导下经皮穿刺置管引流。结果9例病人全部治愈,包括1例暴发急性胰腺炎,无1例需手术治疗,腹腔引流管置留时间为5~7d,胰周引流管置留时间为7~60d(平均30d),住院时间32~152d,平均68d。结论超声引导经皮置管引流对于重症急性胰腺炎腹腔积液较多者,以及胰腺周围积液合并感染者能够进行简便、安全、有效的治疗,它的成功应用为非手术治疗重症急性胰腺炎提供了有益的经验。

The Clinical Value of Ultrasound-guided Percutaneous Tube Drainage in Treatment for Ssevereacute Pancreatitis

Objective To explore the clinical value of ultrasound-guided percutaneous tube drainage in treatment for severe acute pancreatitis.Methods Nine cases of severe acute pancreatitis were treated with multipie non-surgical methods including ultrasound-guide precutaneous tube drainage from Jan,2002 to Jun,2004.To the 6 cases that combined with peritoneal exudates,parcutaneous tubes were placed under the guidance of ultrasound for the aim of drainafe and peritoneal lavage.The 4 cases that combined with peripancreatic fluid collection and infection,percutaneous tube drainage was also performed under the guidance of ultrasound.Results All of the 9oatients were cured without surgical intervention,including 1 case of fulminant acute pancreatits.The period of peritoneal drainage was 5 to 7 days,and the time of peripancreatic drainage was 7 to 60 days(mean 30 days).The hospitalization time was 32 to 152 days (mean 68 days).Conclusion Ultrasound-guided percutaneous tube drainge is a convenient,safe and effective treatment for severe acute pancreatitis combining with large amount of peritoneal exudete or peripancreatic fluid and infection.Its successful application can provide useful experience for non-surgical treatment for sever acute pancreatitis.