摘要
探讨治疗重症急性胰腺炎 (SAP )的手术时机和手术方法。方法 分析 78例SAP患者的临床资料。结果 手术治疗 67例。经腹腔穿刺抽出血性腹水的患者按双盲法随机分为两组 :单纯腹腔置管术组 ( 3 5例 )。经腹壁向腹腔内置管 ,手术后采用闭式灌洗。3 5例中 4例手术后因成人型呼吸窘迫征 (ARDS)死亡 ,3 1例存活 ,其中 6例出现假性囊肿 ;改良手术组 ( 3 2例 )。行胆囊切除、胆总管探查、空肠造瘘及大网膜切除术 ,手术中尽可能不干扰胰腺。 32例患者全部存活 ,均未行第 2次手术 ,无假性囊肿形成。非手术治疗 11例 ,经腹腔穿刺未抽出明显腹水者 ,采用保守治疗 ,全部存活。结论 当SAP患者腹腔穿刺抽出血性腹水 (不论颜色深浅 )就应该及时手术 ,手术尽可能不干扰胰腺 。
Objective To study the timing and procedure of operation for severe acute pancreatitis(SAP). Methods The clinical data of 78 cases of SAP was analysed retrospectively. Results (1) Surgical treatment: 67 cases with abdominal blood liquid were randomly divided into two groups: (a) simple abdominal dranage groups: 35 patients. They were lavaged from the tubes. Four patients with ARDS were dead after operations, others survived; (b) modified operation group: 32 patients. The operation consisted of cholecystectomy, choledochostomy, jejunostomy and great omentum resection; the pancreas was not operated. All of the patients survived. (2) No operation group: 11 patients without any liquid in abdomen were treated with non operation treatment. All of the 11 patients survived. Conclusions The surgical treatment should be performed on the SAP patient with abdominal blood liquid, but the pancreas should not be operated to keep the integrity of pancreas.
出处
《中国普通外科杂志》
CAS
CSCD
2000年第3期206-209,共4页
China Journal of General Surgery
关键词
胰腺炎
诊断
并发症
外科手术
PANCREATITIS/diag
PANCREATITIS/surg
PANCREATITIS/compl
ACUTE DISEASE
