重症急性胰腺炎伴明显腹腔积液腹腔穿刺引流的最佳时间窗及预后
| 作者: |
1李晓明,
2于晶,
3王丰艳
1 青岛市立医院西院区消化内科，青岛 266002 2 青岛市立医院西院区内镜室，青岛 266002 3 青岛市立医院西院区普外科，青岛 266002 |
| 通讯: |
王丰艳
Email: 22665232@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.07.011 |
摘要
目的：探讨重症急性胰腺炎(severe acute pancreatitis，SAP)伴明显腹腔积液腹腔穿刺引流(abdominal puncture drainage，APD)的最佳时间窗及对患者预后的影响。方法：回顾性分析108例SAP伴明显腹腔积液患者的临床资料，根据入院7 d内接受APD时机不同，分为A组(入院2 d内)46例和B组(入院3~7 d内)62例。比较两组SAP患者入院后进阶率、病死率、炎症相关指标、急性生理学与慢性健康状况评分II(Acute Physiology and Chronic Health Score II，APACHE II)评分、器官衰竭个数及住院时间等预后指标。结果：A组入院4周内SAP进阶率低于B组，差异有统计学意义(P<0.05)；A组入院7 d时血清超敏C反应蛋白(high sensitivity C-reactive protein，hs-CRP)、降钙素原(procalcitonin，PCT)、白介素-6(interleukin-6，IL-6)、白介素-8(interleukin-8，IL-8)水平和APACHE II评分均低于B组，器官衰竭个数和住院时间少于B组，差异有统计学意义(均P<0.05)。结论：SAP伴明显腹腔积液患者入院2 d内可能是APD的最佳时间窗，对病情转归和预后改善有益。
关键词：
重症急性胰腺炎；腹腔积液；腹腔穿刺引流；最佳时间窗；预后状况
Best time window of abdominal puncture drainage in severe acute pancreatitis with obvious ascites and its prognosis
CorrespondingAuthor: WANG Fengyan Email: 22665232@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.07.011
Abstract
Objective: To explore the best time window of abdominal puncture drainage (APD) in severe acute pancreatitis (SAP) with obvious ascites and its influence on the prognosis of patients. Methods: The clinical data of 108 SAP patients with obvious ascites were retrospectively analyzed. According to the different time of receiving APD within 7 days, they were divided into group A (46 cases within 2 days of admission) and group B (62 cases within 3~7 days of admission). The progression rate, mortality, inflammation related indexes, APACHE II score, organ failure number and hospitalization time were compared between the two groups. Results: The SAP progression rate in the group A was lower than that in the group B within 4 weeks after admission, and the difference was significant (P<0.05). The serum levels of hs-CRP, PCT, IL-6, IL-8 and APACHE II score in the group A were lower than those in the group B at 7 d after admission, and the number of organ failures and length of hospital stay were lower than those in the group B at 7 d after admission, and the differences were significant (P<0.05).Conclusion: SAP patients with obvious ascites within 2 days of admission may be the best time window for APD, which is beneficial to the prognosis.
Keywords：
severe acute pancreatitis; ascites; abdominal puncture drainage; optimal time window; prognosis