| Objective: This paper is aimed to evaluate the efficacy of percutaneous catheter drainage(PCD)in patients with severe acute pancreatitis(SAP)complicated with Acute pancreatic fluid collections(AFPCs)from the patients related characteristics(sex,age,related laboratory and biochemical indexes)to evaluation the curative effect of puncture and drainage with different paths.In order to improve the clinicians,understandings of APFCs and PCD to guide the clinical treatment,improve the cure rate,reduce the complications and mortality and alleviate the pain of patients and the burden of society.Methods: Collectig the clinical datas of patients(62 cases)hospitalized in the Department of Digestive department,affiliated to Yijishan Hospital of Wannan Medical College from October 2015 to February 2018.All the patients were diagnosed with SAP complicated with APFCs and estimated with Ranson Score,24 h APACHEII score and CTSI.There were 21 cases were treated without drainage,the remaining 41 cases were catheterized drainage group,12 cases of peripancreatic drainage,21 cases of abdominal drainage,8 cases of abdominal combined with peripancreatic drainage.Analysis the clinical characteristics in each group,The clinical characteristics of each group were analyzed and compared.By evaluating the general condition of admission(age,24 h APACHEII score,CTSI score and Ranson score)the incidence of complications(MODS,glucose metabolism disorder and abdominal infection)the prognosis(CRP,the time of hospitalization,mortality)so as to analyze the effect of drainage.Results:In our study the total of 62 cases were collected,including 27 males and 35 females,aged 22-92 years,with an average age of 61.1 ±15.4 years old.Among them,21 cases were non-drainage treatment group with an average age of 61.5 ±18.3 years old,the remaining 41 cases were drainage group.The mean age was 60.8 ±13.9 years old.In the drainage group,12 cases were peripancreatic drainage(mean age:63.1 ±15.9years old),21 cases were abdominal drainage(mean age :61.5 ±13.2 years old),8 cases were combined with abdominal combined with peripancreatic(mean age: 55.4±12.7years old),and the average hospitalization time was 51.3±9.2 days in nondrainage group and 42.1 ±13.9 days in drainage group,the differences were statistically significant(t=2.732,P=0.008).It can be concluded that puncture drainage therapy can shorten the hospitalization time;the normal time of CRP in non-drainage group is 30.3±13.1 days and 21.0 ±11.4 days in drainage group.The differences were statistically significant(t=2.504,P=0.018).The time for CRP to return to normal in peripancreatic drainage group was 15.5 ±11.2 days and 23.8 ±12.7 days in abdominal drainage group,the differences were statistically significant(t=-2.088,P=0.047).The effect of peripancreatic drainage was more obvious.The incidence of MODS in the non-drainage group was 42.9%,and that in the drainage group was 17.1% the differences were statistically significant(X2 =4.822,P=0.028).In this study,the incidence of complications was 53.2%(33/62).The highest incidence of complications was 71.4%(15/21)in the non-drainage group and 33.3%(4/12)in the peripancreatic drainage.The differences were statistically significant(X2=4.537,P=0.033).It can be concluded that peripancreatic drainage can reduce the incidence of complications.Conclusion:(1)PCD can reduce the occurrence of complications such as MODS and shorten the time of CRP recovery and hospitalization;(2)Peripancreatic drainage can reduce inflammation,shorten the time of CRP recovery and reduce the incidence of complications;(3)Combined drainage can shorten the time of hospitalization;(4)PCD can not reduce mortality nor the decreased the occurrence of glucose metabolism disorder and abdominal infection.(5)Postscript: The study lack enough observed cases,especially in the combined drainage group,that may cause the deviation of data results,and need to be verified by large sample data. |
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