经皮穿刺置管引流在重症急性胰腺炎治疗中应用时机的选择对患者预后影响

目的本研究旨在评估经皮穿刺置管引流(percutaneous catheter drainage,PCD)在重症急性胰腺炎(severe acute pancreatitis,SAP)治疗中应用时机的选择对患者结局和并发症方面的影响。方法回顾性分析2018年1月1日至2018年12月31日德阳市人民医院胰腺中心收治的75例接受PCD治疗的SAP患者的临床资料,研究患者的临床表现、PCD应用时期及其疗效。结果75例SAP患者中液体聚集期(ANC期)51例(68%),包裹坏死形成期(WON期)24例(32%),死亡0例(0%),治愈70例(93.3%),5例(6.7%)行进一步外科治疗。两期的平均PCD放置持续时间、并发症发病率(胰瘘、导管阻塞或脱落、出血)差异无统计学意义(P>0.05)。结论PCD在SAP不同阶段(ANC期和WON期)的应用不影响其安全性和疗效,延迟使用并不能取得较好的疗效。

To explore the timing of percutaneous catheter drainage in fluid aggregation and encapsulation necrosis of acute necrotizing pancreatitis

Objective To assess the impact of timing of percutaneous catheter drainage(PCD)application(ANC and WON)on outcomes and complications in severe acute pancreatitis(SAP)treatment.Methods The clinical data of 75 SAP patients treated with PCD from Jan.1,2018 to Dec.31,2018 in Pancreatitis Treatment Center of Deyang People’s Hospital were retrospectively analyzed.The clinical manifestations,application period and curative effect of PCD were analyzed.Results Among the 75 patients,51(68%)were ANC patients,(32%)were WON patients,0(0%)died,70(93.3%)were cured,and 5(6.7%)underwent further surgical treatment.There was no significant difference between the average time of PCD application,or complications(such as pancreatic fistulae,catheter obstruction or falling and haemorrhage)(P>0.05).Conclusion Percutaneous catheter drainage in different stages of acute necrotizing pancreatitis does not affect its safety and efficacy,and delayed use don’t have better curative effect.