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CT-guided percutaneous puncture with drainage tubes of different diameters for severe acute pancreatitis |
LV Hehe, GAO Ming, WANG Wei, LI He |
Department of Emergency Surgery, the Second Hospital of Anhui Medical University, Hefei 230601,China |
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Abstract Objective To investigate the clinical efficacy of CT-guided percutaneous puncture with drainage tubes of different diameters for severe acute pancreatitis.Methods Thirty-six patients with severe acute pancreatitis admitted to the Emergency Department of the Second Affiliated Hospital of Anhui Medical University between October 2015 and October 2017 were enrolled in this retrospective study. The observation group included 18 patients who had larger-diameter drainage tubes (21-30F)implanted , while the other 18 patients (the control group) use dsmall-diameter drainage tubes (10-20F). Such parameters as the time taken by the recovery of clinical symptoms , length of hospital stay, the time it took laboratory indexes and SIRS scores to return to normal were compared between the two groups.Results The time it took abdominal pain to disappear after treatment in the observation group and the control group was (3.74±1.11,5.27±1.21) d, the time taken by the relief of abdominal distension was (8.87±1.37,11.42±1.69) d, the time white blood cells took to return to normal was (7.78±0.81, 11.47±1.34) d, platelet count was (6.93±0.88,8.15±1.59) d, blood amylase was (6.23±0.71,7.71±0.58) d, and lipase was (8.21±0.83,10.28±0.93) d.The difference was statistically significant (P<0.05). The total length of hospital stay of the observation group and the control group was (17.93±0.51,18.09±0.74) d, and the time taken by blood glucose recovery was (10.44±1.11,10.09±0.89) d, but there was no significant difference between the two groups. The SIRS scores after catheterization were significantly higher than before catheterization. (P<0.05).Conclusions The use of drainage tubes of larger diameters in CT-guided percutaneous puncture can more effectively improve the clinical symptoms and reduce the degree of inflammation than that of small-diameter ones. It can play an important role in improving the curative effect of severe acute pancreatitis.
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Received: 30 March 2018
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[1] |
杨耀成,黄耿文,李宜雄,等.经皮穿刺置管引流治疗急性胰腺炎合并坏死感染的预后分析[J].肝胆胰外科杂志,2015,27(2):94-96,99.
|
[2] |
Brun A,Agarwal N,Pitchumoni CS. Fluid collections in and around the pancreas in acute pancreatitis[J]. J Clin Gastroenterol,2011,45(7):614-625.
|
[3] |
高 明,项和平,李 贺,等.血清Ghrelin及胸腔积液变化对急性胰腺炎患者病情的评估价值[J].重庆医学,2015,44(1):71-72,79.
|
[4] |
Wereszczynska S U,Swidnicka S A,Siemiatkowski A,et al.Early enter nutrition is superrior to delayed enter nutrition for the prevention of infected necrosis and mortality in acute pancreatitis[J].Pancreas,2013,42(4):640-646.
|
[5] |
Ke L,Ni H B,Tong Z H,et al. The importance of timing of decompression in severe acute pancreatitis combined with abdominal compartment syndrome[J]. J Trauma Acute Care Surg,2013,74(4):1060-1066.
|
[6] |
郑慧瑛,谢 于,王瑞玲,等.经腹膜后途径CT引导下穿刺引流治疗重症急性胰腺炎临床分析[J].中国现代普通外科进展,2014,17( 11) : 901-902.
|
[7] |
李能平.《2012版急性胰腺炎分类:亚特兰大国际共识的分类和定义的修订》解读[J]. 中华胰腺病杂志,2013,13(3):148-151.
|
[8] |
詹苏东,彭 涛,陶 京,等.早期腹腔穿刺引流治疗重症急性胰腺炎[J].中华普通外科杂志,2012,27(9):717-720.
|
[9] |
唐 明,陈 楠.重症急性胰腺炎的CT各种分级评价及动态CT意义[J]. 临床消化病杂志,2009,21(6):374-376.
|
[10] |
罗 静,彭秋生,姚欣敏.CT引导下经皮穿刺抽液引流诊治急性胰腺炎局部并发症(附24例报告)[J].华西医学,2007,22(4):735-737.
|
[11] |
Gregoric P,Sijacki A,Stankovic S,et al.SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors[J].Hepatogastroenterology,2010,57(98):349-353.
|
[12] |
中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].临床外科杂志,2015,23(1):1-4.
|
[13] |
芦 波,钱家鸣.重症急性胰腺炎病因及发病机制研究进展[J].中国实用外科杂志,2012,32(7):590-592.
|
[14] |
周 波,戴飞跃,翁国虎.连续性血液净化治疗重症急性胰腺炎10例[J].武警医学,2015,26(5):505-506.
|
[15] |
黄耿文,申鼎成.意大利重症急性胰腺炎共识指南(2015)解读[J]. 中国普通外科杂志,2016,25(3):313-317.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(11): 1017-1020. |
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