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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis.
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CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis.

机译：CT引导的急性坏死性胰腺炎经皮导管引流：无菌和感染性坏死患者的临床经验和观察。

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OBJECTIVE: The purpose of this study was to report on clinical experience with and observations made during primary CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis and to compare results among patients with sterile and those with infected necrosis. MATERIALS AND METHODS: We reviewed clinical, radiologic, and bacteriologic data on 35 patients (23 men, 12 women; mean age, 50 years; range, 21-83 years) with acute necrotizing pancreatitis refractory to standard medical care who underwent CT-guided percutaneous catheter drainage with 12- to 22-French catheters. Experiences with two subgroups were compared. One group consisted of 22 patients, 10 with multisystem organ failure, who presented with sterile necrosis (median Atlanta score, 1.3; range, 0-3). The other group consisted of 13 patients, one with multisystem organ failure, who presented with infected necrosis (median Atlanta score, 0.4; range, 0-3). Differences between the group with sterile and the group with infected necrosis were analyzed with the Fisher-Holton exact and Mann-Whitney U tests. RESULTS: Among 35 patients, 17 (49%) were treated successfully with CT-guided percutaneous catheter drainage alone. The effectiveness of CT-guided percutaneous catheter drainage in patients with sterile necrosis (11/22, 50%) was not significantly different from that of drainage in patients with infected necrosis (6/13, 46%). Among 11 patients with multisystem organ failure (10 with sterile necrosis, one with infected necrosis), only four (36%) were treated successfully with CT-guided percutaneous catheter drainage alone; five patients (45%) died. Among 24 patients without multisystem organ failure, 13 (54%) were treated successfully with CT-guided percutaneous catheter drainage alone; one patient died. CONCLUSION: In our experience, primary CT-guided percutaneous catheter drainage was successful for approximately one half of the patients with acute necrotizing pancreatitis. The presence of multisystem organ failure appears to be a more important indicator of outcome than does the presence of infection.
机译：目的：本研究的目的是报告急性坏死性胰腺炎的CT引导下经皮导管引流的临床经验和观察，并比较不育患者和感染性坏死患者的结果。材料和方法：我们回顾了35例接受CT引导的标准医疗难以治愈的急性坏死性胰腺炎的患者（23例男性，12例女性;平均年龄50岁;范围21-83岁）的临床，放射学和细菌学数据经12至22根法线导管经皮引流。比较了两个亚组的经验。一组包括22例患者，其中10例患有多系统器官衰竭，表现为无菌性坏死（中位数亚特兰大评分，1.3;范围0-3）。另一组由13例患者组成，其中1例患有多系统器官衰竭，表现为感染性坏死（中位数亚特兰大评分，0.4;范围0-3）。使用Fisher-Holton精确检验和Mann-Whitney U检验分析了无菌组和坏死感染组之间的差异。结果：在35例患者中，仅用CT引导的经皮导管引流成功治疗了17例（49％）。 CT引导的经皮导管引流在无菌性坏死患者中的效果（11 / 22，50％）与感染坏死患者的引流效果（6 / 13，46％）没有显着差异。在11例多系统器官衰竭患者中（10例为无菌坏死，1例为感染性坏死），仅4例（36％）仅通过CT引导的经皮导管引流成功治疗。五名患者（45％）死亡。在24例无多系统器官衰竭的患者中，仅使用CT引导的经皮导管引流术成功治疗了13例（54％）。一名病人死亡。结论：根据我们的经验，在大约一半的急性坏死性胰腺炎患者中，CT引导的经皮导管引流成功。与感染相比，多系统器官衰竭的出现似乎是预后更重要的指标。

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