摘要
目的研究胰腺手术后出血(PPH)的相关因素、诊断及治疗。方法对2003-2007年北京大学临床肿瘤学院北京肿瘤医院胰腺手术的临床资料进行分析,对术后并发症进行分类统计,就出血相关因素、临床表现、处理方法与结果进行分析。结果236例中33例发生PPH,其中栓塞治疗4例,手术治疗7例,内镜止血1例,死亡6例,其余均行内科保守治疗。结论PPH与腹腔积液、胰瘘、手术方式等因素相关,与病人性别、年龄、病理类型、是否有胃排空障碍、是否术前减黄、胰腺吻合方式等因素无关。胰瘘发生后需早期引流、冲洗,预防出血。根据不同出血类型选择处理方式,尽量行血管造影检查,明确出血部位并行初步处理。
Objective To investigate the risk factors, diagnosis and treatment for post pancreatectomy hemorrhage（PPH）. Methods The clinical data of patients performed pancreatic surgery between 2003 and 2007 at Beijing Cancer Hospital were analyzed retrospectively. The data included bleeding risk factors, clinical presentation, management and outcome. Results Among 236 cases, PPH occurred in 33 cases. Four of 33 cases were performed angiography and embolism. Seven cases performed surgery. One case performed endoscopy. Six cases died. Others performed medical treatment. Conclusion Pyoperitoneum, pancreatic fistula and surgery choice are important factors in the pathogenesis of PPH, other than factors such as sex, age, pathology, delayed gastric emptying, etc. Early drain is essential after pancreatic fistula. Angiography should be considered firstly to confirm the bleeding source.
出处
《中国实用外科杂志》
CSCD
北大核心
2010年第2期108-110,121,共4页
Chinese Journal of Practical Surgery
关键词
胰腺手术后出血
胰瘘
止血
post pancreatectomy hemorrhage
pancreatic fistula
hemostasia
