洪雪竹 张志强

[摘要] 目的 分析對重症胰腺炎患者行经皮腹腔穿刺引流治疗的临床效果。 方法 选取我院接受治疗的重症胰腺炎患者70例，以随机数字表法为分组依据分为两组，每组患者35例。对照组实施超声引导经皮腹膜后穿刺置管引流术治疗，观察组实施经皮腹腔穿刺引流治疗。对比两组患者术后外周血白细胞恢复正常的时间、膀胱压改善情况、微循环改善情况、器官衰竭发生情况以及住院时间。 结果 治疗后，观察组患者的住院时间、器官衰竭率、血淀粉酶恢复正常天数及治疗后外周血白细胞降至正常参考范围内所需时间均显著优于对照组，观察组患者的APACHE-Ⅱ评分及膀胱压显著低于对照组患者（P<0.05）;观察组患者的PGI2（173.29±10.01）pg/mL显著高于对照组患者的PGI2（145.22±8.81）pg/mL（P<0.05）;观察组患者的TXA2（145.54±12.33）pg/mL，显著低于对照组患者的TXA2（220.32±16.54）pg/mL（P<0.05）;治疗后观察组总有效率显著高于对照组（P<0.05）。 结论 对重症胰腺炎患者行经皮腹腔穿刺引流治疗能够有效缩短患者术后外周血白细胞恢复正常的时间，缩短患者住院时间，降低患者器官衰竭发生率，有效改善微循环指标以及生理健康，显著降低膀胱压，有较高的临床应用价值。

[关键词] 重症胰腺炎;经皮腹腔穿刺引流;外周血白细胞;器官衰竭发生率

[中图分类号] R657.51          [文献标识码] B          [文章编号] 1673-9701（2021）11-0048-04

Application of percutaneous peritoneal drainage in the treatment of severe pancreatitis

HONG Xuezhu1   ZHANG Zhiqiang2

1.Graduate School of China Medical University， Shenyang   110122， China; 2.Department of General Surgery， People′s Hospital of China Medical University， Shenyang   110016， China

[Abstract] Objective To analyze the clinical effect of percutaneous peritoneal drainage treatment in patients with severe pancreatitis. Methods Seventy patients with severe pancreatitis who were treated in our hospital were selected and divided into two groups based on the random number table method， with 35 patients in each group. The control group was treated with ultrasound-guided percutaneous retroperitoneal puncture and drainage， and the observation group was treated with percutaneous peritoneal drainage. The time for the recovery of peripheral blood white blood cells， the improvement of bladder pressure， the improvement of microcirculation， the occurrence of organ failure， and the length of stay in the two groups were compared. Results After treatment， the hospitalization time， organ failure rate， the number of days for blood amylase to return to normal， and the time required for peripheral blood leukocytes to fall within the normal reference range after treatment in the observation group were significantly better than those in the control group. The APACHE-Ⅱ score and bladder pressure in the observation group were significantly lower than those in the control group（P<0.05）. The PGI2（173.29±10.01） pg/mL of the observation group was significantly higher than the PGI2（145.22±8.81） pg/mL of the control group（P<0.05）. TXA2（145.54±12.33） pg/mL of the observation group was significantly lower than that（220.32±16.54） pg/mL of the control group（P<0.05）. The total effective rate of the observation group after treatment was significantly higher than that of the control group（P<0.05）. Conclusion Percutaneous peritoneal drainage treatment for patients with severe pancreatitis can effectively shorten the time for patients to return to normal peripheral blood leukocytes after surgery， shorten the patient′s hospital stay， reduce the incidence of organ failure， and make the microcirculation index and physical health effectively improved and the bladder pressure significantly reduced， which has high clinical application value.

[Key words] Severe pancreatitis; Percutaneous peritoneal drainage; Peripheral blood leukocytes; The incidence of organ failure

重癥胰腺炎属于临床患病率较高的急腹症，主要致病原因为胰管黏膜屏障受到激活的消化酶原刺激而受损诱发[1]。该疾病的主要临床表现为血胰酶显著增加、呕吐、恶心、腹痛、发热。结合患者的患病程度可分为胰腺坏死以及胰腺水肿两种，如未及时给予有效治疗，极易并发脓毒血症、消化道出血，对患者的生命安全造成严重威胁[2]。手术为该疾病的首选治疗方案，传统的开腹手术创口面积较大，还需要将引流管置入患者体内，会诱发新的并发症发生[3-4]。故目前临床多选用穿刺引流治疗，经皮腹膜后穿刺以及经皮腹腔穿刺……