摘要
目的探讨CT平扫后以骨性标志指导重型胰腺炎穿刺引流的临床有效性及安全性。方法选择济宁医学院附属医院兖州院区2017年3月至2018年3月接受CT平扫后以骨性标志指导穿刺引流治疗的重型胰腺炎患者33例,其中膈下脓肿1例,急性梗阻性胆囊炎3例,胰周坏死性积液3例,大量胸腔积液20例,大量腹腔积液6例,观察治疗结果及穿刺相关问题。结果33例患者中,除1例胰周坏死性积液难以穿刺引流外,其余全部顺利置管引流,穿刺引流后患者临床症状及体征明显缓解,成功率达96.9%。结论CT平扫后以骨性标志指导穿刺引流治疗重型胰腺炎并发感染性休克、中重度积液伴有血流动力学不稳定、腹腔脓肿引发脓毒性休克、急性梗阻性胆囊炎、感染性休克,操作安全、有效,符合损伤控制外科理念。
Objective To investigate the clinical efficacy and safety of puncture and drainage guided by bony markers after computed tomography(CT) plain scan. Methods Thirty-three patients with severe pancreatitis who underwent CT scan guided by bony markers from March 2017 to March 2018 in the Affiliated Hospital of Jining Medical College were selected. Among them, there was 1 case of subphrenic abscess, 3 cases of acute obstructive cholecystitis, 3 cases of peripancreatic necrosis effusion, 20 cases of large number of pleural effusion, 6 cases of large number of ascites. The treatment results and puncture related problems were observed. Results In addition to 1 case who failed to receive puncture drainage for peri-pancreatic necrotic effusion, all of the others were successfully placed in the drainage tube. The clinical symptoms and signs of the patients were relieved after puncture and drainage. The success rate was 96.9%. Conclusions The effect of puncture and drainage guided by bony markers after CT plain scan on severe pancreatitis with inferctious shock, moderate and severe effusion with hemodynamic instability, septic shock caused by abdominal abscess, acute obstructive cholecystitis and infectious shock is good and it is safe. It is consistent with the concept of injury control surgery.
作者
付金涛
闫慧
Fu Jintao;Yan Hui(The Affiliated Hospital of Jining Medical College, Jining 250000, China)
出处
《中国实用医刊》
2019年第6期30-34,共5页
Chinese Journal of Practical Medicine
关键词
重型胰腺炎
中重度积液
经皮穿刺引流
Severe pancreatitis
Moderate and severe effusion
Percutaneous drainage
