恶性梗阻性黄疸手术后并发症及其防治  

Postoperative complications and perioperative treatment for malignant obstructive jaundice

作　　者：任智[1,2] 庞全贵 李正中[1,2] 赵秉化 李士骏[1,2] 

机构地区：[1]山西医科大学第一临床医学院普外科 [2]山西侯马市人民医院

出　　处：《山西医科大学学报》1997年第2期118-120,共3页Journal of Shanxi Medical University

摘　　要：恶性梗阻性黄疸９７例，男７３例，女２４例。平均年龄５３．２岁。行Ｗｈｉｐｐｌｅ手术３０例，胆囊癌或胆管癌切除１６例，姑息性内引流１５例，外引流术６例，单纯剖腹探查２０例。术后并发症１６．５％，病死率８．２％。本组术后并发症包括：急性肾衰３．１％、消化道出血２．１％、肝昏迷１％、高血糖症１％、感染性休克１％、切口哆开６．２％。术后并发症组病死率明显高于无并发症组（Ｐ＜０．０００１）。积极做好围手术期处理，减少术后并发症，是降低病死率的关键。Ninety seven patients with malignant obstructive jaundice were reviewed.There were 73 males and 24 females,aged 24 to 78 years.Whipple's procedure was performed in 30 patients,tumor resection in 16 patients,and exploratory laparotomy in the other 20 patients.Incidence of postoperative complcations and mortality occured in 16 5% and 8 2%,respectively.Postoperative complications associated with surgical mortality included acute renal failure,gastrointestinal hemorrhage,hepatic coma,hyperglycemia,septic shock,and wound dehiscence,with incidence of 3 1%,2 1%,1%,1%,1% and 6 2%,respectively.Mortality was much higher in malignant jaundiced patients with postoperative complications than those without postoperative complications(P<0 000 1).Intensive perioperative management is very important to reduce complications.

关 键 词：胆道 胰腺 黄疸 胆汁郁积 肿瘤 并发症 

分 类 号：R657.406[医药卫生—外科学] R619[医药卫生—临床医学]