Application of CEUS-guided interventional therapy in severe acute pancreatitis
LEI Zhihui1, ZHANG Yao2, DENG Qing2
1. Department of Medical Imaging, Hubei Provincial Corps Hospital of Chinese People’s Armed Police Force, Wuhan 430061, China; 2. Department of Ultrasound, People’s Hospital of Wuhan University, Wuhan 430060, China
Abstract：Objective To evaluate the application value of contrast-enhanced ultrasound (CEUS)-guided interventional therapy in severe acute pancreatitis. Methods A total of 98 patients diagnosed with severe acute pancreatitis were selected from the People's Hospital of Wuhan University from January 2020 to November 2022, and divided into drainage group (n=51) and control group (n=47) according to whether interventional treatment was performed. The two groups were treated with oxygen inhalation, gastrointestinal decompression, anti-infection, anti-shock, correction of water, electrolyte and acid-base imbalance, etc. The drainage group received ultrasound-guided tube drainage on the day of admission on the basis of the above treatment. The patients in the drainage group underwent routine ultrasound examination first, underwent CEUS examination to examine inside and around the lesions, the puncture path was designed at the areas with good liquefication in the lesions, a drainage catheter was inserted into the lesion and the location of the catheter was confirmed to be correct, and the nature and amount of drainage fluid were recorded after surgery. The changes were evaluated by monitoring clinical indicators before and after catheterization in the two groups, including the evaluation of efficacy, intra-abdominal pressure, acute physiological and chronic health score (APACHEII), monitoring of liver and lung function, and comparison of inflammatory indicators on day 3, day 5, and day 10 after admission. Results The curative effect of the drainage group was significantly better than that of the control group. The effective rate of the drainage group was 50.98% (26/51), a recovery rate was 41.18% (21/51), and the total effective rate was 92.16% (47/51), while the effective rate of the control group was 34.04% (16/47), the improvement rate was 40.43% (19/47), and the total effective rate was 74.47% (35/47). The intra-abdominal pressure and APACHEII score of the drainage group decreased more significantly (P<0.001), and the inflammatory indexes including white blood cell count, blood amylase, blood lipase, C-reactive protein, procalcitonin, and blood calcium showed a downward trend after surgery, and were significantly better than the control group, with the most significant difference between the two groups on the 5th day after admission (all P<0.05). The liver and lung function of the drainage group recovered faster than the control group, and AST, ALT, PaO2 and oxygenation index increased more significantly on the 3rd and 5th day after admission (P<0.05). Conclusions CEUS-guided catheter drainage can effectively treat complications associated with severe acute pancreatitis and temporally delay disease progression, thus serving as an effective approach in clinical treatment of severe acute pancreatitis.
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2024, Vol. 35 
