目的探讨超声引导经皮穿刺置管引流术在重症急性胰腺炎(SAP)治疗中的应用价值。方法对我院2001年 1 月至2009年12 月期间收治的35例腹腔渗液较多及合并胰腺周围积液、假性胰腺囊肿及脓肿的SAP患者采用了超声引导经皮穿刺置管引流术，观察其疗效。结果35例患者，置管引流45例次，置管成功率为100%。4例(11.4%)中转开腹手术，31例(88.6%)置管能有效引流。2例(5.7%)穿刺后并发少量出血。结论选择性应用超声引导经皮穿刺置管引流术对于腹腔积液较多及合并局部并发症的SAP患者，是一种有效的治疗手段。
ObjectiveTo investigate the therapeutic effect of B ultrasound-guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site in treatment of hyperlipidemic severe acute pancreatitis (HL-SAP). MethodsThe clinical data of 34 patients with HL-SAP initially underwent B ultrasound-guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site from January 2010 to June 2014 were retrospectively analyzed. According to the different of the onset to treatment time, 34 cases were divided into the≤24 h group and > 24 h group. The serum platelet activating factor (PAF) and triglyceride (TG) at the time of admission and after admission 1, 3, 5, 7, and 10 days were detected, and the hospitalization time, mortality, and the rate of conversion to open surgery were observed. ResultsThe levels of PAF and TG in the both groups tended to gradually decrease with different degrees, were significantly lower than that the before treatment (P < 0.05), and the decline of PAF and TG in≤24 h group were more significant than > 24 h group. The hospitalization time, mortality, and the rate of conversion to open surgery in the≤24 h group were significantly lower than those of the > 24 h group (P < 0.05). ConclusionThe early using of B ultrasound-guided percutaneous catheter drainage combined with veno-venous hemofiltration at different time points and multi-site would have a beneficial impact on the management of HL-SAP and complications.