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经皮导管引流技术细节对感染性坏死性胰腺炎患者临床结局的影响。

The effect of technical details of percutaneous catheter drainage on the clinical outcomes of infected necrotizing pancreatitis patients.

机构信息

Department of General Surgery, Beijing Xuanwu Hospital, Capital Medical University, Beijing, P.R. China

Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, P.R. China

出版信息

Turk J Med Sci. 2019 Aug 8;49(4):1079-1084. doi: 10.3906/sag-1805-111.

Abstract

BACKGROUND/AIM: This study aimed to investigate the effect of technical details of percutaneous catheter drainage (PCD) on the clinical outcomes of patients with infected necrotizing pancreatitis (INP).

MATERIALS AND METHODS

A total of 44 INP patients treated in our hospital from October 2013 to October 2015 were included. The correlations of the first PCD treatment data and the clinical outcomes were analyzed.

RESULTS

The number of catheters was positively correlated with hospital readmission (r = 0.335, P = 0.032). Receiver operating characteristic curve analysis showed that patients with ≥ 3 catheters were more likely to have hospital readmission. Patients with pleural effusion undergoing thoracentesis were more likely to have new intensive care unit admission (P = 0.025) and bleeding in need of intervention (P = 0.032). Patients with more effusion regions had higher incidences of mortality (P = 0.012) and new intensive care unit admissions (2.44 ± 1.03 vs. 1.88 ± 0.80; P = 0.059). Patients with PCD only were less likely to have new intensive care unit admissions (22.22% vs. 54.55%; P = 0.038) than those with PCD + small incision or/and videoscopic assisted retroperitoneal debridement.

CONCLUSION

Number of catheters greater than three was associated with unfavorable outcomes of PCD treatment in INP patients. Patients that received PCD treatment only had better outcomes.

摘要

背景/目的:本研究旨在探讨经皮导管引流(PCD)的技术细节对感染性坏死性胰腺炎(INP)患者临床结局的影响。

材料与方法

选取我院 2013 年 10 月至 2015 年 10 月收治的 44 例 INP 患者,分析首次 PCD 治疗数据与临床结局的相关性。

结果

置管数量与住院再入院呈正相关(r = 0.335,P = 0.032)。受试者工作特征曲线分析显示,置管数≥3 根的患者更有可能再次住院。并发胸腔积液行胸腔穿刺的患者更有可能再次入住重症监护病房(P = 0.025)和需要介入治疗的出血(P = 0.032)。有更多积液区域的患者死亡率(P = 0.012)和再次入住重症监护病房的发生率更高(2.44 ± 1.03 比 1.88 ± 0.80;P = 0.059)。仅接受 PCD 治疗的患者较接受 PCD+小切口或/和腹腔镜辅助腹膜后清创术的患者再次入住重症监护病房的可能性更小(22.22%比 54.55%;P = 0.038)。

结论

置管数大于 3 根与 INP 患者 PCD 治疗的不良结局相关。仅接受 PCD 治疗的患者结局更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7350/7018392/2c7a44dbcee4/turkjmedsci-49-1079-fig001.jpg

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