目的探讨经皮穿刺置管引流术(PCD)治疗急性胰腺炎合并坏死感染的临床疗效。方法回顾性分析106例急性胰腺炎合并坏死感染患者的临床资料,其中采用经皮穿刺置管引流术治疗的51例作为观察组,采用开腹手术引流治疗的55例作为对照组。比较两组引流液的细菌培养情况、相关实验室指标及手术疗效。结果与术前相比,术后两组患者血淀粉酶、WBC、尿淀粉酶、血钙、血糖、TNF-α、PCT及IL-8水平均显著降低(P<0.05),且观察组尿淀粉酶、血淀粉酶、血糖、TNF-α、PCT及IL-8水平明显低于对照组,差异有统计学意义(P<0.05);两组术后WBC和血钙水平的下降程度相当,差异无统计学意义(P>0.05)。观察组与对照组治疗有效率(80.39% vs 78.18%)比较,差异无统计学意义(P>0.05)。结论经皮穿刺置管引流术治疗急性胰腺炎合并坏死感染的临床疗效显著,术后能够显著改善患者的相关实验室指标,胰腺功能恢复较快,值得在临床上进一步推广。
ObjectiveTo explore the clinical efficacy of percutaneous catheter drainage (PCD) in the treatment of acute pancreatitis complicated with necrotic infection. MethodsClinical data of 106 patients with acute pancreatitis complicated with necrotic infection were retrospectively analyzed. Fifty-one cases treated with PCD was enrolled as observation group, and 55 cases treated with open drainage as control group.The bacterial culture result of drainage fluid, the relevant laboratory indices and the surgical efficacy were compared between the two groups. ResultsAfter operation, the levels of blood amylase, WBC, urinary amylase, serum calcium, blood glucose, TNF-α, PCT and IL-8 in both groups were significantly lower compared to the preoperative levels (all P<0.05). The levels of urinary amylase, blood amylase, blood glucose, TNF-α, PCT and IL-8 in the observation group were significantly lower than those in the control group (all P<0.05). But there were no significant differences in the descending levels of WBC and serum calcium between the two groups(all P>0.05). And significant difference in the effective rate was also not observed between the two groups (80.39% vs. 78.18%, P>0.05). ConclusionThe PCD can achieve a significant clinical efficacy for patients with acute pancreatitis complicated with necrotic infection, can significantly improve the relevant laboratory indices of patients and accelerate the recovery of pancreatic function after operation. Therefore,it is worthy of further clinical promotion.