| Objective:Through retrospective analysis of relevant clinical data of patients with severe acute pancreatitis(SAP),the therapeutic effect of percutaneous puncture and catheter drainage(PCD)for early acute volume aggregation(AFCs)in SAP patients and the relationship between puncture time,location and infection were discussed to provide theoretical basis for accurate management of early AFCs in SAP.Method:The data of cases diagnosed as severe acute pancreatitis from October 2016 to February 2019 in our hospital's emergency intensive care unit and intensive surgical ICU were collected and screened according to inclusion criteria and exclusion criteria.A total of 82 patients were screened out(one of them failed to enter the group).81 SAP patients were divided into puncture group and control group according to whether percutaneous puncture and drainage were performed two weeks before onset,43 patients in puncture group and 38 patients in control group.The incidence of complications,SIRS duration,infection and pseudocyst formation were compared between the two groups to evaluate the safety and effectiveness of treatment.The puncture time was further divided into ?1 week group and 1-2 weeks group to explore the relationship between early PCD treatment and infection.According to the different indwelling positions of PCD therapeutic catheters,they are grouped again to explore the differences in the characteristics and laboratory results of different puncture positions.In order to realize accurate management of liquid accumulation in acute pancreatitis by controlling different times and positions.Result:Inflammatory indexes such as WBC,CRP,PCT and the like of SAP patients in the puncture group and the control group are significantly increased at the time of admission.Compared with the control group,SRIS duration and late complications of the two groups of patients after active puncture and drainage treatment can be improved in the puncture group,and the recovery time of each index in the puncture group is lower than that of the control group,with statistical significance(P < 0.05),while the infection incidence difference between the two groups is not statistically significant(P > 0.05).The puncture group was further divided into ?1 week group and 1-2 week group according to puncture time for statistical analysis.the leukocytes in drainage fluid of the 1-2 week group were different(P=0.036),and the results of positive culture rate were also different(P=0.03),which indicated that the infection risk was also increasing with the extension of liquid accumulation time,and the volume of liquid accumulation around pancreas,multiple organ failure and infection indicated by CT had statistical differences(P< 0.05),which was one of the factors that might cause secondary infection in its early stage.Compared with abdominal puncture group,retroperitoneal puncture has thicker properties,and there is a statistical difference in tube plugging rate,infection rate and SIRS recovery time between the two groups(P < 0.05).Conclusions:1.Early percutaneous catheter drainage can reduce the duration of SIRS,reduce the length of hospitalization,and reduce medical expenses.PCD treatment will not increase its associated infection.2.With the extension of acute fluid accumulation time in the early stage of acute severe pancreatitis,the infection risk of fluid accumulation increases.Multiple organ failure is one of the risk factors for infection.PCT is obviously related to the occurrence of MOF in the early stage of SAP,but it cannot be proved to be significantly related to the occurrence of infection.3.Compared with the peritoneal puncture group,the drainage fluid properties and biochemical indexes of the retroperitoneal puncture group are different,and the infection risk of the retroperitoneal puncture group is higher. |
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