CAJ | 학술논문

目的探讨影像引导经皮穿刺置管灌洗引流在重症急性胰腺炎（ SAP ）早期治疗中应用的可行性、临床价值与技术特点。方法选自我院2008年9月至2010年2月收治的SAP患者56例，随机分为影像引导下经皮穿刺置管灌洗引流治疗组（简称治疗组）（n＝27）和常规保守治疗组（简称对照组）（n＝29），检测两组患者治疗前后的实验室指标，对比两组患者治疗后恢复情况及疗效。结果治疗后两组患者血白细胞计数、血糖、血钙、血、尿淀粉酶等指标出现显著性差异（P＜0.05），症状体征消失天数、恢复饮食天数、总住院天数等也均有显著性差异（P＜0.01）。治疗组死亡率明显低于对照组（7.4％ vs．20.7％，P＜0.05），有效率则高于对照组（88.9％vs．65.5％，P＜0.05）。结论影像引导经皮穿刺置管灌洗引流是SAP早期治疗中一种安全可行的方法，其用微创的方法达到开腹手术全面探查、充分灌洗引流治疗SAP 的目的，值得临床推广应用。
목적탐토영상인도경피천자치관관세인류재중증급성이선염（ SAP ）조기치료중응용적가행성、림상개치여기술특점。방법선자아원2008년9월지2010년2월수치적SAP환자56례，수궤분위영상인도하경피천자치관관세인류치료조（간칭치료조）（n＝27）화상규보수치료조（간칭대조조）（n＝29），검측량조환자치료전후적실험실지표，대비량조환자치료후회복정황급료효。결과치료후량조환자혈백세포계수、혈당、혈개、혈、뇨정분매등지표출현현저성차이（P＜0.05），증상체정소실천수、회복음식천수、총주원천수등야균유현저성차이（P＜0.01）。치료조사망솔명현저우대조조（7.4％ vs．20.7％，P＜0.05），유효솔칙고우대조조（88.9％vs．65.5％，P＜0.05）。결론영상인도경피천자치관관세인류시SAP조기치료중일충안전가행적방법，기용미창적방법체도개복수술전면탐사、충분관세인류치료SAP 적목적，치득림상추엄응용。
Objective To discuss the feasibility , clinical value and technical features of image-guided percutaneous tube lavaged and drainage in the early treatment of severe acute pancreatitis ( SAP ) .Methods 56 patients with severe acute pancreatitis in our hospital from September 2008 to February 2010 were randomly divided into two groups which were treated with image ( ultrasonic or CT combined ) guided percutaneous catheter lavage and drainage (n=27) and conservative methods respectively (control group) (n=29).Laboratory data of both groups were obtained before and after treatment;recovery and efficacy after treatment were compared between these two groups;medical statistics analysis were made.Results After treatment,there were significant differences in white blood cell count,blood sugar,blood calcium and amylase in blood and urine between treatment group and control group ( P<0.05 ) ,and there were significant differences ( P<0.01 ) in the time of relief from abdominal pain , of resume eating days ,duration ,etc between these two groups .The mortality of treatment group were significantly lower than the control group(7.4% vs.20.7%).At the same time the cure rate of the former was higher than the latter (88.9%vs.65.5%).Conclusions Image-guide percutaneous tube lavage and drainage is feasible and safe for the early treatment of SAP .It can achieve the same results of complete exploration , sufficient peritoneal lavaged and drainage by laparotomy in a minimally invasive way .Thus it is worthy of popularization in clinical practice .