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本文引用的文献

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CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis.CT引导下经皮导管引流治疗急性坏死性胰腺炎：无菌性和感染性坏死患者的临床经验与观察
AJR Am J Roentgenol. 2009 Jan;192(1):110-6. doi: 10.2214/AJR.08.1116.
2
Severe acute pancreatitis in China: etiology and mortality in 1976 patients.中国的重症急性胰腺炎：1976例患者的病因及死亡率
Pancreas. 2007 Oct;35(3):232-7. doi: 10.1097/MPA.0b013e3180654d20.
3
Computed tomography severity index and C-reactive protein values predicting mortality in emergency and intensive care units for patients with severe acute pancreatitis.计算机断层扫描严重程度指数和C反应蛋白值对重症急性胰腺炎患者在急诊科和重症监护病房死亡率的预测作用
Am J Surg. 2007 Jul;194(1):30-4. doi: 10.1016/j.amjsurg.2006.08.089.
4
Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study.早期抗生素治疗重症急性坏死性胰腺炎：一项随机、双盲、安慰剂对照研究。
Ann Surg. 2007 May;245(5):674-83. doi: 10.1097/01.sla.0000250414.09255.84.
5
Percutaneous drainage of infected pancreatic fluid collections in critically ill patients: correlation with C-reactive protein values.危重症患者感染性胰液积聚的经皮引流：与C反应蛋白值的相关性
Clin Imaging. 2006 Mar-Apr;30(2):114-9. doi: 10.1016/j.clinimag.2005.09.026.
6
Clinical laboratory assessment of acute pancreatitis.急性胰腺炎的临床实验室评估
Clin Chim Acta. 2005 Dec;362(1-2):26-48. doi: 10.1016/j.cccn.2005.06.008. Epub 2005 Jul 18.
7
Acute pancreatitis and organ failure: pathophysiology, natural history, and management strategies.急性胰腺炎与器官衰竭：病理生理学、自然病程及管理策略
Curr Gastroenterol Rep. 2004 Apr;6(2):99-103. doi: 10.1007/s11894-004-0035-0.
8
CT-guided percutaneous peripancreatic drainage: a possible therapy in acute necrotizing pancreatitis.CT引导下经皮胰腺周围置管引流：急性坏死性胰腺炎的一种可能治疗方法。
Hepatogastroenterology. 2002 Nov-Dec;49(48):1696-8.
9
Computed tomography severity index is a predictor of outcomes for severe pancreatitis.计算机断层扫描严重程度指数是重症胰腺炎预后的一个预测指标。
Am J Surg. 2000 May;179(5):352-5. doi: 10.1016/s0002-9610(00)00375-5.
10
[Percutaneous drainage of infected pancreatic necrosis: an alternative to surgery].
Chirurgie. 1999 Feb;124(1):31-7. doi: 10.1016/s0001-4001(99)80039-7.

超声引导下经皮置管引流在重症急性胰腺炎早期治疗中的应用。

Ultrasound-guided percutaneous catheter drainage in early treatment of severe acute pancreatitis.

机构信息

Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Ai XB, Pan WS, Wu LQ, Zhang WJ) Department of Gastroenterology, Zhuhai People's Hospital, Third Affiliated Hospital of Jinan University School of Medicine, Zhuhai 519000, China (Ai XB, Wang A); Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Qian XP); Department of Ultrasonography, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Xu J).

出版信息

World J Emerg Med. 2010;1(1):45-8.

PMID:25214940
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4129772/
Abstract

BACKGROUND

Percutaneous catheter drainage (PCD) is a minimally invasive intervation for severe acute pancreatitis (SAP). This study was undertaken to compare the results of surgery and ultrasound-guided PCD in the treatment of 32 patients with SAP, and to direct clinicians to the most optimal approach for SAP.

METHODS

In the 32 patients, 19 were proved to have deteriorated clinical signs or symptoms, extensive fluid exudation, and necrosis confirmed by computed tomography (CT) and they underwent operative debridement and drainage. For extensive fluid exudation or necrosis, complete liquefaction and safe catheter implantation, the other 13 patients were given PCD.

RESULTS

The mortality rate of the surgery group was 26.3%, much higher than that of the PCD group (0%). There was a significant difference between the two groups (P=0.044). The mean time for recovery of the serum C-reactive protein (CRP) level was 43.8 days in the surgery group, which was significantly longer than that of the PCD group (23.8 days) (P=0.034).

CONCLUSION

Early PCD guided by ultrasound could decrease the mortality of patients with severe acute pancreatitis, alleviate life-threatening inflammatory complications, and avoid unnecessary emergency operation.

摘要

背景

经皮导管引流（PCD）是治疗重症急性胰腺炎（SAP）的一种微创介入方法。本研究旨在比较手术和超声引导下 PCD 在治疗 32 例 SAP 患者中的结果，为临床医生提供 SAP 最佳治疗方法的指导。

方法

在这 32 例患者中，19 例患者的临床症状或体征恶化，广泛的液体渗出，CT 证实有坏死，行手术清创和引流。对于广泛的液体渗出或坏死，为了实现完全液化和安全的导管植入，另外 13 例患者接受了 PCD。

结果

手术组的死亡率为 26.3%，明显高于 PCD 组（0%）（P=0.044）。两组之间有显著差异。手术组血清 C 反应蛋白（CRP）水平恢复正常的平均时间为 43.8 天，明显长于 PCD 组（23.8 天）（P=0.034）。

结论

超声引导下早期进行 PCD 可降低重症急性胰腺炎患者的死亡率，减轻危及生命的炎症并发症，并避免不必要的急诊手术。