摘要
目的 探讨重症急性胰腺炎 (SAP)术后并发肠瘘的原因及防治手段。方法 对 1996年 1月至 2 0 0 0年 12月间手术治疗的 82例 SAP进行回顾性分析 ,并对可能导致肠瘘发生的危险因素和采用的治疗方法进行总结。结果 82例手术治疗的 SAP发生肠瘘 2 0例 ,其中结肠瘘 15例 ,十二指肠瘘 5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 .0 5 ) ;早期手术 (<2周 )较后期手术 (>2周 )发生率高 (P<0 .0 5 ) ;蝶形引流术较经后上腰引流术发生率高(P<0 .0 5 )。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和手术方式有关。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 。
Objective To investigate the cause and treatment for the fistula complicated by severe acute pancreatitis(SAP).Methods A retrospective analysis was made on 82 SAP cases admitted from Jan.1995 to Dec 2000 in order to evaluate the risk factor of complicated fistula and surgical management Results The fistula developed in 20 cases out of 82 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).The patients of undergoing posterior drainage were more prone to fistula than those receiving butter pattern drainage( 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
《四川医学》
CAS
2002年第1期28-29,共2页
Sichuan Medical Journal
