[1]陶 伟,昝建宝,宋康颉,等.腹腔穿刺引流时机对中度重症急性胰腺炎预后的影响[J].医学信息,2022,35(07):137-140.[doi:10.3969/j.issn.1006-1959.2022.07.035]
　TAO Wei,ZAN Jian-bao,SONG Kang-jie,et al.Effect of Timing of Abdominal Paracentesis Drainage on Prognosis of Moderate Severe Acute Pancreatitis[J].Medical Information,2022,35(07):137-140.[doi:10.3969/j.issn.1006-1959.2022.07.035]
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腹腔穿刺引流时机对中度重症急性胰腺炎预后的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年07期
页码:
137-140
栏目:
临床研究
出版日期:
2022-04-01

文章信息/Info

Title:
Effect of Timing of Abdominal Paracentesis Drainage on Prognosis of Moderate Severe Acute Pancreatitis
文章编号:
1006-1959（2022）07-0137-04
作者:
陶 伟; 昝建宝; 宋康颉; 等
（安徽医科大学附属安庆医院普外科，安徽 安庆 246003）
Author(s):
TAO Wei; ZAN Jian-bao; SONG Kang-jie; et al.
(Department of General Surgery,Anqing Affiliated Hospital,Anhui Medical University,Anqing 246000,Anhui,China)
关键词:
中度重症急性胰腺炎; 腹水; 穿刺时机; 腹腔穿刺引流
Keywords:
Moderate severe acute pancreatitis; Ascites; Timing of puncture; Abdominal paracentesis drainage
分类号:
R576
DOI:
10.3969/j.issn.1006-1959.2022.07.035
文献标志码:
A
摘要:
目的 评估不同腹腔穿刺引流（APD）时机对中度重症胰腺炎伴腹水患者预后转归的影响。方法 以2019年9月-2021年5月安徽医科大学附属安庆医院收治的84例中度重症胰腺炎患者作为研究对象。根据患者入院1周内是否行腹腔穿刺引流术将其分为APD组（56例）和非APD组（28例），另外将APD组依据穿刺时间分为0~3天内APD组和4~7天内APD组，比较三组患者住院时间、住院费用、炎症指标（CRP、WBC、PCT、IL-6、TNF-α）、器官衰竭程度、进阶率及死亡率。结果 0~3天内APD组患者病死率为0，进阶率为7.1%，低于4~7天内APD组的3.58%、32.14%及非APD组的17.86%、35.71%，差异有统计学意义（P＜0.05）；0~3天内APD组器官的衰竭程度优于4~7天内APD组和非APD组，差异有统计学意义（P＜0.05）；0~3天内APD组WBC、CRP、PCT、IL-6、TNF-α降低优于4~7天内APD组和非APD组，差异有统计学意义（P＜0.05）；0~3天APD组住院时间、住院费用低于4~7天内APD组和非APD组，差异有统计学意义（P＜0.05）。结论 对于明显伴有腹腔积液的中度重症胰腺炎患者，早期最佳的腹腔穿刺引流时间窗为0~3天内，该法可改善中度重症胰腺炎患者的预后，降低其炎症水平，提高其生存率。
Abstract:
Objective To evaluate the effect of different timing of abdominal paracentesis drainage (APD) on the prognosis of patients with moderate severe pancreatitis with ascites.Methods Eighty-four patients with moderate severe pancreatitis admitted to Anqing Affiliated Hospital, Anhui Medical University from September 2019 to May 2021 were divided into APD group (56 cases) and non-APD group (28 cases) according to whether abdominal puncture drainage was performed within one week of admission. In addition, APD group was divided into APD group within 0-3 days and APD group within 4-7 days according to puncture time. The hospitalization time, hospitalization expenses, inflammatory indexes (CRP, WBC, PCT, IL-6, TNF-α), organ failure degree, progression rate and mortality rate of the three groups were compared.Results The mortality rate of patients in the APD group within 0-3 days was 0, and the progressive rate was 7.1%, which was lower than 3.58% and 32.14% in the APD group within 4-7 days and 17.86% and 35.71% in the non-APD group, and the difference was statistically significant (P<0.05). The organ failure degree of APD group within 0-3 days was better than that of APD group within 4-7 days and non-APD group, and the difference was statistically significant (P<0.05). The decrease of WBC, CRP, PCT, IL-6 and TNF-α in APD group within 0-3 days was better than that in APD group within 4-7 days and non-APD group, and the difference was statistically significant (P<0.05). The hospitalization time and hospitalization expenses of APD group within 0-3 days were lower than those of APD group within 4-7 days and non-APD group, and the difference was statistically significant (P<0.05).Conclusion For patients with moderate severe pancreatitis significantly associated with peritoneal effusion, the early optimal peritoneal puncture drainage time window is within 0-3 days. This method can improve the prognosis of patients with moderate severe pancreatitis, reduce the inflammatory level and improve the survival rate.

参考文献/References:

[1]刘静,吴瑞钧.B超引导下经皮穿刺抽液置管引流术对重度急性胰腺炎患者临床疗效及血清S-Amy、LPS的影响[J].检验医学与临床,2021,18(8):1146-1149.[2]张立翱,杨宁,何雪.早期足量体液复苏对急性中重度胰腺炎的疗效观察[J].解放军预防医学杂志,2019,37(7):84-85,88.[3]Manrai M,Kochhar R,Gupta V,et al.Outcome of acute pancreatic and peripancreatic collections occurring in patients with acute pancreatitis[J].Ann Surg,2018,267(2):357-363.[4]杨熊,刘若鸿,谢川,等.早期腹腔穿刺引流对重症急性胰腺炎肾损伤的保护作用[J].中国普通外科杂志,2021,30(3):321-329.[5]罗文婷,谭碧君,甘田,等.超声引导经皮腹膜后穿刺置管引流前腹腔穿刺引流治疗重症急性胰腺炎的临床价值[J].临床外科杂志,2019,27(5):412-415.[6]马军伟,卢启国.急性胰腺炎合并液体积聚患者在经皮穿刺置管引流前行腹腔穿刺引流治疗效果探讨[J].现代消化及介入诊疗,2017,22(1):110-113.[7]廖东平,张霓,伍文才,等.低分子肝素联合血必净注射液对重症急性胰腺炎患者IL-6、P-选择素、D-二聚体的影响及临床意义[J].吉林医学,2021,42(6):1380-1383.[8]Crockett SD,Wani S,Gardner TB,et al.American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis[J].Gastroenterology,2018,154(4):1096-1101.[9]范光明.早期经皮穿刺置管引流对重症急性胰腺炎伴胰源性腹腔积液患者脏器功能衰竭和预后的影响[J].山西医药杂志,2020,49(17):2336-2338.[10]马力,李晓锋,熊燃,等.中度重症急性胰腺炎早期超声引导下经皮穿刺置管引流术的临床价值[J].新医学,2021,52(2):116-119.[11]陈新,崔季钊,李博学,等.介入置管引流治疗重症胰腺炎局部并发症的临床研究[J].中外医学研究,2020,18(3):17-18.[12]李松.超声引导下经皮穿刺置管引流术对重症胰腺炎合并胰周脓肿患者的疗效[J].河南医学研究,2019,28(5):827-829.[13]申建刚,李俊达,叶石才,等.基于高通量测序技术的轻度急性胰腺炎病程中肠道微生态变化[J].中华消化杂志,2019,39(10):690-693.[14]王如意,昝建宝,何承龙,等.序贯性早期肠内营养在中度重症急性胰腺炎患者治疗中的作用[J].医学信息,2019,32(23):89-92.[15]王鸿,胡颖.高三酰甘油血症性急性胰腺炎预后的危险因素以及防治策略分析[J].胃肠病学,2020,25(1):23-27.[16]王军锋,李娜,罗卿.腹腔镜手术治疗重症急性胰腺炎及对TNF-α、IL-6和sIL-2R水平的影响[J].中国内镜杂志,2017,23(11):74-78.[17]姜伟,孟珂伟,盛冠男,等.SOFA评分联合IL-6检测对复杂腹腔感染患者预后评估价值[J].中华医院感染学杂志,2019,29(7):980-983.

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更新日期/Last Update: 1900-01-01