摘要
目的探讨重症急性胰腺炎(SAP)术后并发肠瘘的诊断和治疗。方法对1999年8月～2008年12月手术治疗的89例SAP进行回顾性分析,探讨可能导致肠瘘发生的危险因素及其诊断治疗。结果治疗的SAP发生肠瘘16例,其中结肠瘘10例,十二指肠瘘6例,均出现在术后两周内,有胰腺感染的较无感染的发生率高(P<0.05);早期手术较后期手术(2周)发生率高(P<0.05)。结论SAP术后的肠瘘与胰外炎性浸润,手术创伤以及手术时机的选择有关。肠瘘的治疗应充分考虑原发病的状况,并根据肠瘘的位置、局部炎症的情况,早期通过加强营养支持,保持瘘口周围引流通畅,多数肠瘘可自行愈合,后期少数不愈合肠瘘和考虑手术治疗。
Objective To investigate the diagnosis and treatment for the fistula complicated by severe acute pancreatitis（SAP）. Methods A retrospective analysis was made on 89 SAP cases admitted from Aug. 1999 to Dec. 2008 in order to evaluate the risk factor of complicated fistula and surgical management. Results The fistula developed in 16 cases out of 89 case undergoing surgery, all were within 2 weeks postoperations. The fistula developed more commonly in those with peripancreatic inflammatory infiltration than those without（P〈0.05）. The likelihood of fistula was larger in those undergoing surgery within 2 weeks than after 2 weeks of the onset of SAP（P〈0.05）. Conclusion The fistula after the operation of SAP is deeply related to peripancreatic inflammatory infiltration. The trauma of operation,the time and methods of operation. By using nutritional support and keeping drainage of fistula, most of the fistula can close up naturally. Just a few of fistula which can not close up should be operated in the later.
出处
《当代医学》
2009年第22期84-85,共2页
Contemporary Medicine
关键词
重症急性胰腺炎
肠瘘
外科手术
severe acute Pancreatitis
Fistula
Surgery operative
