胰瘘临床治疗分析40例  

Rational therapy for pancreatic fistula: an analysis of 40 cases

作　　者：赵栋[1] 田力[2] 侯静[1] 

机构地区：[1]首都医科大学附属北京同仁医院ICU,北京市100730 [2]吉林大学附属中日联谊医院基本外科,吉林省长春市130033

出　　处：《世界华人消化杂志》2008年第27期3114-3117,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨胰瘘的治疗方法.方法:回顾性分析1992-01/2002-12吉林大学附属中日联谊医院发生胰瘘的40例患者,其中,外伤术后20例,急性胰腺炎术后14例,胰十二指肠切除术后4例,其他2例.结果:醋酸奥曲肽明显能够减少腹腔引流液淀粉酶含量和引流量(1144±974.48IU/Lvs12306.33±21448.46IU/L,120.83±119.12mL/dvs262.22±212.35mL/d,均P<0.05).本组接受非手术治疗30例,有效治疗率为90%;接受再次手术治疗10例,有效治疗率为70%.临床吻合口瘘组与生化吻合口瘘组相比较,再次手术几率高,有效治疗率明显低于后者,住院时间明显延长(均P<0.05).结论:生长抑素明显能够减少腹腔引流液量,对治疗胰瘘有一定作用.大多数胰瘘能够通过非手术方法得到有效的治疗.AIM： To explore rational therapeutic methods of pancreatic fistula （PF）. METHODS： A retrospective analysis was per-formed of 40 PFs from Jan. 1992 to Dec. 2002 in-cluding 20 cases from traumatic complications, 14 cases from acute pancreatitis, 4 cases from pancreaticoduodenectomy and 2 cases from other diseases. RESULTS： Somatostatin significantly reduced amylase and volume of drainage （1144 ± 974.48 IU/L vs 12306.33 ± 21448.46 IU/L, 120.83 ± 119.12 mL/d vs 262.22 ± 212.35 mL/d, both P 〈 0.05）. Conservative management were used in 30 patients, and the effective rate was 90%; 10 patients underwent re-operation and the effec-tive rate was 70%. Compared with biochemical pancreatic anastomotic leak group, clinical pan-creatic anastomotic leak group had higher re-op-erative rate, lower effective rate, and prolonged hospital stay （all P 〈 0.05）.CONCLUSION： Somatostatin significantly re-duces amylase and volume of drainage and proves effective for pancreatic fistula. Non-surgical treatment works for most of pancreatic fistula cases.

关 键 词：胰瘘 治疗 醋酸奥曲肽 

分 类 号：R657.5[医药卫生—外科学]