Research Progress On Timing And Efficacy Of Abdominal Puncture Drainage For Acute Severe Pancreatitis

Objective:Severe acute pancreatitis(SAP)is featured in rapid development,extremely dangerous conditions,a great number of complications,high mortality,and extremely tough treatment.It accounts for about 20% among acute pancreatitis,so that it is actually a common surgical acute abdominal disease.With the in-depth research on the treatment of severe acute pancreatitis,the concept of minimally invasive SAP treatment has been widely applied in clinics,which continuously improves the SAP survival rate and greatly reduces the mortality rate.Although the minimally invasive SAP treatment has been constantly advanced and optimized,there still lack unified standard for a lot of detailed problems appeared in SAP treatment process.The percutaneous catheter drainage(PCD)technology has been recognized and reached consensus on the treatment of pancreatic and or surrounding tissue infections.But for pancreatitis-related ascites in the early stage of SAP,it is still in dispute of whether or not to perform abdominal puncture drainage(APD)in early stage.Meanwhile,for SAP patients with a lot of abdominal effusion,the performance of intraperitoneal percutaneous drainage in early stage has been confirmed in a great number of literature.But no consensus about the best timing has been reached up to now,which needs to be further explored and optimized.This paper discussed the timing and efficacy of abdominal puncture and drainage for severe acute pancreatitis and the effect of improving APD at different time on the progression rate of SAP patients.Methods:A retrospective study was conducted on 55 patients with severe acute pancreatitis who were admitted to China-Japan Friendship Hospital of Jilin University from July 2019 to November 2020.The basic data of the patients included the total hospitalization cost,length of stay,basic information,blood biochemical indexes,systemic and local complications,etc.Inclusion criteria :1)acute severe pancreatitis;2)abdominal imaging findings of abdominal effusion ≥100ml after admission;3)18 years old ≤75 years old;4)the time from onset to visit ≤48 hours.Exclusion criteria :1)pancreatitis secondary to surgery or ERCP,and 2)pancreatitis secondary to malignant tumor.Accord with a standard,a total of 55 cases of patients according to the patients admitted to hospital after abdominal puncture time grouping of 0-2 days,3 to 5 days,6 days or more,compare different puncture time of patients with severe acute pancreatitis abdominal puncture after hospitalization days,total cost of treatment,blood biochemical indicators,state of illness,such as organ failure situation,analysis of APD time affecting the efficacy of treatment of severe acute pancreatitis,the collected data using statistical software SPSS23.0 statistical analysis,the accord with normal distribution measurement data contrast using analysis of variance between groups,such as:Indexes such as hospital cost,length of stay,PCT,severity of the disease score,and counting data such as organ failure and progression rate were tested by chi-square test.P < 0.05 was considered statistically significant.The results are analyzed and discussed,and the final conclusion is drawn.Result:Through the data calculation,the results show that the hospital expenses,length of hospital stay,PCT,and illness severity score accord with normal distribution,the variance analysis,the result reality 0 to 2 days and 3 to 5 days and 6 days or more group compared with the difference was statistically significant(P < 0.05)between group rate of organ failure and advanced by chi-square test,the results showed that each group difference was statistically significant(P < 0.05)by comparison with the relevant indexes of three groups of patients can be found,in a clear diagnosis and intervention indications of severe acute pancreatitis by APD 0 to 2 days,Hospitalization cost,length of stay,PCT,severity score,organ failure and progression rate were shortened,decreased or decreased compared with other groups.In general,it can be concluded that APD within 0-2 days of severe acute pancreatitis has positive significance for the prognosis of patients.Conclusion:1.The best apd for patients with severe acute pancreatitis accompanied by paaf was returned to the hospital for two days.2.In patients with severe acute pancreatitis with PAAF,completion of APD within 0-2 days after admission can reduce the probability of progression.