目的    探讨经皮穿刺置管引流治疗重症急性胰腺炎的价值和时机。方法    回顾性分析北京协和医院2007年1月至2012年3月收治的29例重症急性胰腺炎病人（男性18例，女性11例；年龄23~79岁，平均38岁）的临床资料。所有病人接受了CT引导下经皮穿刺置管（管径大小10~18 F）引流治疗。结果    29例病人中，25例（86.2%）穿刺引流治疗有效，其中有19例免于外科手术，有6例于穿刺引流后14~49d（中位时间23d）接受了外科手术治疗；4例（13.8%）引流治疗无效的病人，均死于感染和器官功能衰竭。有1例发生穿刺引流后出血。结论    当保守治疗重症急性胰腺炎无效时，经皮穿刺治疗引流可以有效地控制胰腺坏死、感染引起的全身脓毒症状，为择期外科手术治疗创造条件，甚至可以免于外科手术治疗。

Clinical study of percutaneous catheter drainage in 29 cases severe acute pancreatitis        PAN Jie*, SHI  Hai-feng, LI Xiao-guang, et al. *Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730
Corresponding author: Yang Ning  E-mail：markpan6885@qq.com
Abstract    Objective    The purpose of this study was to investigate the value and the timing of percutaneous catheter drainage in the treatment of severe acute pancreatitis. Methods    We retrospectively studied the clinical data of 29 patients (18 men, 11 women; mean age, 38years; range, 23~79 years) with severe acute pancreatitis at Peking Union Medical College Hospital from January 2007to March 2012. All the patients underwent CT-guided percutaneous catheter drainage with 10~18 French catheters. Results    Among 29 patients, 25(86.2%) were treated effectively with CT-guided percutaneous catheter drainage including 19 obviated the need for surgery and 5 underwent surgical intervention 14~49 days (mean 23 days) after drainage. 4 patients(13.8%) were not effectively treated with percutaneous catheter drainage, who were died from infection and organ failure. One patient had bleeding after drainage. Conclusions    When severe acute pancreatitis patients could not have been successfully treated conservatively, the percutaneous catheter drainage could effectively control the sepsis caused by pancreatic necrosis and infection. It could act as a bridge to selective surgery and even obviate the need for surgery.