摘要
以改善胰腺微循环为主的内外科综合疗法连续治愈7例重症胰腺炎病人。治疗结果表明,在当今习用的内外科综合疗法的同时,应用人血清白蛋白、654—2、低分子右旋糖酐和溶栓酶类等药物来改善患胰的微循环,可使在手术切除坏死组织后,防止尚有生机的残胰组织继续坏死,避免多次手术切胰,从而提高对重症胰腺炎的治愈率。辅助手术不必将“三造瘘”列为常规,以减少对病人的创伤,但空肠营养造痿应作为常规,以保障病人在术后的营养摄入。早期抗生素的应用,应选择能通过血胰屏障的药物,使胰腺实质内也能获得足够的浓度,以提高控制胰腺本身感染的效果。
Seven cases of acute necrotic pancreatitis were treated by restoring the microcirculation of the affected pancreas in our hospital from March 1985 to January 1991. There were no mortality and few complications in this series. The methods used to restore the microcirculation of the affected pancreas were the medication of human serum albumin for releasing the edema in the pancreas; 654-2, an antispastic agent for the arteriole, including the efferent arteriole of the islets; dextran-40 for decreasing the blood viscocity and urokinase or ancrod for resolving the microthrombi which might develope in the inflamed pancreas. The advantage of this procedure is to be able to make a functioning microcirculation for the organs. Furthermore, it can avoid further necrosis to the affected pancreas and then increase the cure-rate up to the best record as 100% (7/7) in this series. Of course, we should combine this procedure with the ordinary treatments which have already been used in most hospitals. As is our experience, the jejunostomy as a route for nutrition supply is necessary to most cases, whereas the gastrostomy and the choledochostomy should be performed individually according to the patient's actual conditions. The antibiotics with the effect to penetrate the blood-pancreas barrier should be first selected before the others.
出处
《河南医科大学学报》
1992年第1期25-28,共4页
Journal of Henan Medical University
关键词
胰腺炎
微循环
综合疗法
treatment
pancreatitis
microcirculation
nutritional jejunostomy
blood-pancreas barrier
