保守治疗和经皮导管引流可改善坏死性胰腺炎的预后。

Conservative treatment and percutaneous catheter drainage improve outcome of necrotizing pancreatitis.

作者信息

Sun Junjun, Yang Cheng, Liu Weifeng, Yang Yanhui, Qi Shifang, Chu Zhijie, Xin Shiyong, Zhang Xiaohui

出版信息

Hepatogastroenterology. 2015 Jan-Feb;62(137):195-9.

Abstract

BACKGROUND/AIMS: To investigate the clinical effects of the maximum conservative treatment algorithm with percutaneous catheter drainage (PCD) as the first choice for necrotizing pancreatitis (NP).

METHODOLOGY

Retrospectively analyzed NP patients who had fine needle aspiration (FNA) for proven infection of necrosis which was considered an indication for surgery (n=22, group 1) compared to patients subjected to maximum conservative treatment with PCD in NP patients (n=30, group 2).

RESULTS

On admission, most baseline data did not show any statistical difference between the two groups, In group 2, all patients were implemented maximum conservative treatment, 25 of 30 patients were cured by PCD (83.3%), open necrosectomy were needed for 3 patients (10.0%) and 2 dead during hospitalization (6.7%). Whereas, in group 1, surgical operation rate was 45.6% and hospital mortality 31.8%, both of the ratios differed significantly compared with group 2 (45.6% vs. 10%, P=0.004; 31.8% vs. 6.7%, P=0.046 respectively). Furthemore, Hospital stay were significantly higher in group 1 compared with group 2 (90±18.5 vs. 39±13.4; P=0.033).

CONCLUSIONS

A conservative approach with PCD as the first choice to treatment NP might decrease the rate of surgical operation and mortality, and improve the outcome of NP.

摘要

背景/目的：探讨以经皮导管引流（PCD）为首选的最大保守治疗算法对坏死性胰腺炎（NP）的临床疗效。

方法

回顾性分析经细针穿刺抽吸（FNA）证实坏死感染且被视为手术指征的NP患者（n = 22，第1组），并与NP患者中接受以PCD为主的最大保守治疗的患者（n = 30，第2组）进行比较。

结果

入院时，两组间大多数基线数据无统计学差异。在第2组中，所有患者均接受了最大保守治疗，30例患者中有25例通过PCD治愈（83.3%），3例患者需要进行开放性坏死组织清除术（10.0%），2例患者在住院期间死亡（6.7%）。而在第1组中，手术率为45.6%，医院死亡率为31.8%，这两个比率与第2组相比均有显著差异（45.6%对10%，P = 0.004；31.8%对6.7%，P = 0.046）。此外，第1组的住院时间明显长于第2组（90±18.5对39±13.4；P = 0.033）。