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目的:探讨超声引导下经皮穿刺置管引流术治疗重症急性胰腺炎(SAP)合并胰周脓肿的临床疗效。方法:回顾性分析2011年6月—2016年6月收治的68例SAP合并胰周脓肿患者的临床资料,根据治疗方式随机分为观察组(35例)和对照组(33例),观察组接受超声引导下经皮穿刺置管引流术,对照组接受药物保守治疗。记录并分析两组患者腹腔脓肿消失时间、血尿淀粉酶恢复至正常时间、腹部症状及体征消失时间、饮食恢复的时间、平均住院时间、并发症发生率等。结果:与对照组比较,观察组患者治疗后腹腔脓肿消失时间、血淀粉酶恢复正常时间、恢复饮食时间、症状体征消失时间均明显缩短(均P<0.05);治疗有效率明显高于对照组(P<0.05);治疗期间观察组并发症发生率明显低于对照组(P<0.05)。结论:超声引导下经皮穿刺置管引流术治疗SAP继发胰周脓肿的疗效较好,且并发症发生率低、微创、治疗费用低廉,适合各级医院推广应用。
Objective: To investigate the clinical efficacy of ultrasound guided percutaneous catheter drainage in the treatment of severe acute pancreatitis (SAP) combined with peripancreatic abscess. Methods: The clinical data of 68 patients with SAP combined with peripancreatic abscess admitted from June 2011 to June 2016 were retrospectively analyzed. According to the treatment, the patients were randomly divided into observation group (35 cases) and control group (33 cases). The observation group Under the guidance of ultrasound guided percutaneous catheter drainage, the control group received conservative treatment of drugs. The disappearance time of peritoneal abscess, the recovery of hematuria and amylase to normal time, the disappearance of abdominal symptoms and signs, the time of diet recovery, the average length of hospital stay and the complication rate were recorded and analyzed. Results: Compared with the control group, the disappearance time of peritoneal abscess, the recovery time of serum amylase, the time of restoring diet and the disappearance of symptoms and signs were significantly shorter in the observation group (all P <0.05); the treatment efficiency was significantly higher than that in the control group (P <0.05). The incidence of complications in observation group was significantly lower than that in control group during treatment (P <0.05). Conclusion: The percutaneous catheter drainage guided by ultrasound is effective in treating secondary pancreatic peripancreatic abscess with low complication rate and minimal invasion. The treatment cost is low and suitable for all kinds of hospitals.