Clinical study of early catheter drainage to reduce local complications of severe acute pancreatitis
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摘要: 目的 探讨早期置管引流治疗重症急性胰腺炎(severe acute pancreatitis，SAP)胰周积液的临床疗效及对SAP局部并发症的影响。方法 收集本院2017年1月-2022年12月收治SAP患者共42例。观察组25例，早期经皮置管引流胰周积液；对照组17例，行内科保守治疗。回顾性分析两组间临床症状缓解时间、血液指标变化、治疗有效率及局部并发症发生情况。结果 观察组临床症状及实验室指标恢复时间均早于对照组，差异有统计学意义(P＜0.05)；两组间总体有效率差异有统计学意义(P＜0.05)。观察组局部并发症的发生率40%，低于对照组76.5%，差异有统计学意义(P＜0.05)。结论 早期置管引流胰周积液可加快SAP患者恢复，明显降低SAP局部并发症的发生。Abstract: Objective To explore the clinical effect on severe acute pancreatitis(SAP) local complications by early catheter drainage for SAP peripancreatic effusion.Methods A total of 42 cases of SAP patients were collected from January 2017 to December 2022. In the observation group, 25 cases treated with percutaneous catheterdrainage early for peripancreatic effusion. In the control group, 17 cases treated with conservative internal medicine. The clinical symptom relief time, the changes of laboratory indicators and the occurrence of local complications between the two groups were retrospectively analyzed.Results The relief time of clinical symptoms and laboratory indexes in the observation group was earlier than that in the control group(P < 0.05). The effective rate was significant difference between the two groups(P < 0.05). The incidence of local complications in the observation group was 40%, lower than that in the control group(76.5%). The difference between the two groups was statistically significant(P < 0.05).Conclusion Early catheter drainage for peripancreatic effusion of SAP can accelerate the recovery and significantly reduce the local complications of SAP patients.
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表 1 两组患者CRP及PCT动态变化情况对比
X±S 时间 CRP/(mg/L) PCT/(ng/mL) 观察组 对照组 t P 观察组 对照组 t P 第1天 117.12±16.25 120.65±12.11 0.761 0.451 2.58±0.21 2.71±0.24 1.801 0.079 第3天 93.12±11.17 147.76±13.63 14.231 ＜0.05 2.75±0.32 2.92±0.30 1.683 0.100 第5天 87.84±8.22 137.12±11.30 16.380 ＜0.05 1.58±0.33 3.69±0.39 18.837 ＜0.05 第7天 73.56±8.68 95.12±12.43 6.630 ＜0.05 1.03±0.27 2.79±0.43 16.212 ＜0.05 
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表 2 两组患者临床指标恢复时间的情况对比
X±S，d 组别 例数 腹痛时间 胃肠减压时间 发热时间 住院时间 观察组 25 3.28±1.28 7.96±1.93 5.68±1.14 15.16±1.65 对照组 17 6.29±1.61 11.29±2.39 7.89±1.27 20.53±2.10 t 6.756 4.993 5.858 9.277 P ＜0.05 ＜0.05 ＜0.05 ＜0.05
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表 3 两组患者临床效果的对比情况
例(%) 组别 例数 治愈 有效 无效 有效率 观察组 25 15(60.0) 6(24.0) 4(16.0) 21(84.0) 对照组 17 4(23.5) 4(23.5) 9(52.9) 8(47.0) χ2 7.438 P 0.023
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表 4 两组患者局部并发症发生率
组别 例数 治愈/例 并发症/例 发生率/% 观察组 25 15 10 40.0 对照组 17 4 13 76.5 χ2 4.061 P 0.044
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