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目的观察CT引导下多点穿刺引流联合中西医结合治疗重症急性胰腺炎(SAP)并胰腺坏死组织感染的疗效。方法选取医院收治的SAP并胰腺坏死组织感染的患者40例,行CT引导下多点穿刺引流联合中西医结合治疗。比较治疗前和治疗后第3天患者的临床症状、生命体征及各项检验指标与急性生理与慢性健康状况评分(APACHEⅡ),并记录治疗效果。结果患者治疗后第3天临床症状明显缓解,生命体征趋于平稳,各项检验指标与APACHEⅡ评分较治疗前明显降低(P<0.05)。40例患者中34例(85.0%)经治疗后痊愈,避免了开腹手术;5例(12.5%)经治疗后明显减轻了感染中毒症状,后行开腹手术后治愈;1例(2.5%)因多器官功能障碍死亡。结论 CT引导下多点穿刺引流联合中西医结合治疗SAP并胰腺坏死组织感染,可较快改善临床症状、体征及各项检验指标,操作简单安全,创伤小,可减少传统开腹手术。
Objective To observe the curative effect of CT-guided multi-puncture and drainage combined with integrated traditional Chinese and western medicine in the treatment of severe acute pancreatitis (SAP) and pancreatic necrosis tissue infection. Methods Forty patients with SAP infected with pancreatic necrosis tissue were selected and treated with CT-guided multi-point puncture and drainage combined with integrated traditional Chinese and Western medicine. The clinical symptoms, vital signs, test indicators and acute physiology and chronic health status score (APACHEⅡ) were compared before treatment and on the 3rd day after treatment, and the therapeutic effect was recorded. Results The symptoms of the patients were relieved on the 3rd day after treatment. The vital signs tended to be stable. The indexes of examination and APACHE Ⅱ scores were significantly lower than those before treatment (P <0.05). Among the 40 patients, 34 cases (85.0%) were cured after operation, avoiding laparotomy. Five cases (12.5%) were relieved of symptoms of poisoning and were cured after laparotomy. One case (2.5% ) Died of multiple organ dysfunction. Conclusion CT guided multiple puncture and drainage combined with Chinese and Western medicine treatment of pancreatic necrosis of the SAP and SAP infection can be quickly improved clinical symptoms and signs and various test indicators, simple and safe, less trauma, can reduce the traditional open surgery.