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目的探讨超声引导下经皮穿刺置管引流治疗小儿早期胰腺假性囊肿(PPC)的临床价值。方法 1993年1月-2010年1月徐州医学院附属医院15例小儿早期症状性PPC,通过超声检查确定PPC的位置、穿刺的部位、角度及导管置入深度后,在局麻下经皮穿刺囊肿,置入8~10 F引流管行持续外引流,并对引流后的情况进行随访观察。结果 15例患儿均一次穿刺置管成功,穿刺径路包括腹前壁10例,侧腹壁5例。囊壁活检均未发现肿瘤细胞。无并发症发生。术后1周复查血淀粉酶均正常。15例患儿均得到随访,随访4~13个月,平均12个月。其中12例囊肿消失后拔管,随访期间未复发。3例外引流迁延不愈,6周后行手术治疗。结论小儿早期症状性PPC确诊后,采用超声引导经皮置管引流术治疗创伤小,安全有效,并发症少,是一种疗效显著的微创治疗方法。
Objective To investigate the clinical value of ultrasound-guided percutaneous catheter drainage in the treatment of early pancreatic pseudocyst (PPC) in children. Methods From January 1993 to January 2010, 15 cases of pediatric early symptomatic PPC in Xuzhou Medical College Affiliated Hospital were examined by ultrasonography to determine the location of PPC, location of puncture site, angle and depth of catheterization. Percutaneous puncture under local anesthesia Cysts were placed in 8 ~ 10 F drainage tube continuous external drainage, and follow-up observation of the situation after drainage. Results All the 15 children underwent successful puncture and catheterization, including 10 cases of anterior abdominal wall and 5 lateral abdominal wall. Tumor cells were not found on the wall biopsy. No complications occurred. A week after the review of blood amylase were normal. All 15 cases were followed up for 4 ~ 13 months with an average of 12 months. Twelve of them had extubation after the disappearance of the cyst and no recurrence during follow-up. 3 cases of delayed drainage, 6 weeks after surgery. Conclusion Early diagnosis of symptomatic PPC in children after percutaneous catheter drainage with ultrasound-guided traumatic small, safe and effective, less complications, is a minimally invasive treatment of significant effect.