中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (3): 244-246.doi: 10.12007/j.issn.0258-4646.2018.03.012

• 论著 • 上一篇    下一篇

经皮胆囊穿刺引流术辅助治疗重症急性胰腺炎的临床应用价值

谢锋1, 朱芳2, 王红岩3, 刘峥嵘3, 赵晓丹3, 樊小刚4, 韩宏民3   

  1. 1. 中国医科大学人民医院核医学科, 沈阳 110016;
    2. 中国医科大学人民医院心功能科, 沈阳 110016;
    3. 中国医科大学人民医院普外科, 沈阳 110016;
    4. 沈阳出入境检验检疫局国际旅行卫生保健中心, 沈阳 110016
  • 收稿日期:2017-10-18 出版日期:2018-03-30 发布日期:2018-03-24
  • 通讯作者: 朱芳 E-mail:zfmoon@126.com
  • 作者简介:谢锋(1977-),男,副主任医师,博士.
  • 基金资助:
    辽宁省社会发展公关计划(2013225021)

Clinical Application of Percutaneous Gallbladder Drainage in Severe Acute Pancreatitis

XIE Feng1, ZHU Fang2, WANG Hongyan3, LIU Zhengrong3, ZHAO Xiaodan3, FAN Xiaogang4, HAN Hongmin3   

  1. 1. Department of Nuclear Medicine, The People's Hospital of China Medical University, Shenyang 110016, China;
    2. Department of Cardiac Function, The People's Hospital of China Medical University, Shenyang 110016, China;
    3. Department of General Surgery, The People's Hospital of China Medical University, Shenyang 110016, China;
    4. Shenyang Entry-exit Inspection and Quarantine Bureau International Travel Health Care Center, Shenyang 110016, China
  • Received:2017-10-18 Online:2018-03-30 Published:2018-03-24

摘要: 目的 探讨采用经皮胆囊穿刺引流术辅助治疗重症急性胰腺炎的临床应用价值。方法 回顾性分析65例重症胰腺炎患者的临床资料。将患者分为胆囊穿刺组和对照组。随访至少6个月,观察2组的死亡率及胰腺脓肿、假性囊肿、肾功能不全、呼吸衰竭、心功能衰竭、消化道出血、败血症、弥漫性血管内凝血(DIC)等并发症的发生率,并进行统计学分析比较。结果 胆囊穿刺组死亡率低于对照组,差异有统计学意义(P < 0.05);胆囊穿刺组全身并发症(肾功能不全、呼吸衰竭、心力衰竭、消化道出血、败血症)的发生率低于对照组(P < 0.05);胆囊穿刺组局部并发症(胰腺脓肿及假性囊肿)的发生率与对照组无统计学差异(P > 0.05);另外,胆囊穿刺组DIC的发生率低于对照组,但差异无统计学意义(P > 0.05)。结论 经皮胆囊穿刺引流术能够有效降低重症胰腺炎的肾功能不全、呼吸衰竭、心功能衰竭、消化道出血、败血症等全身并发症的发生率,降低死亡率。但对于局部并发症胰腺脓肿和假性囊肿及DIC的发生率没有帮助。

关键词: 经皮胆囊穿刺引流术, 重症胰腺炎, 死亡率, 全身并发症, 局部并发症

Abstract: Objective To investigate the clinical value of percutaneous gallbladder drainage in the treatment of severe acute pancreatitis (SAP). Methods A total of 65 patients treated for SAP in our hospital between January 2014 and April 2017 were analyzed retrospectively. The patients were divided into a gallbladder puncture group and a control group. Follow-up was performed for at least 6 months to monitor mortality and the incidence of complications,including pancreatic abscess,pseudocyst,renal failure,respiratory failure,heart failure,gastrointestinal bleeding,sepsis,and disseminated intravascular coagulation (DIC). The differences in mortality and complication rates between the two groups were statistically analyzed. Results Mortality in the gallbladder puncture group was significantly lower than in the control group (P < 0.05);the incidence of renal failure,respiratory failure,heart failure,gastrointestinal bleeding,and sepsis in the gallbladder puncture group was lower than in the control group (P < 0.05);the incidence of pancreatic abscess and pseudocyst in the gallbladder puncture group was similar to that in the control group,showing no significant difference (P > 0.05);the incidence of DIC in the gallbladder puncture group was lower than in the control group,but the difference was not statistically significant (P > 0.05). Conclusion Percutaneous gallbladder drainage can effectively reduce the incidence of renal failure,respiratory failure,heart failure,gastrointestinal bleeding,and sepsis in SAP,thereby reducing mortality. However,the incidence of DIC,pancreatic abscess,and pseudocyst is not reduced.

Key words: percutaneous gallbladder drainage, severe acute pancreatitis, mortality, systemic complication, local complication

中图分类号: 

  • R45
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