Frey手术治疗慢性胰腺炎的临床疗效分析  

Analysis on Clinical Efficacy of Frey Procedure for Chronic Pancreatitis

作　　者：杜冰清[1] 陈拥华[1] 龚军[1] 郑振江[1] 向光明[1] 刘续宝[1] 麦刚[1] 

机构地区：[1]四川大学华西医院肝胆胰外科,四川成都610041

出　　处：《中国普外基础与临床杂志》2011年第2期187-190,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨Frey手术治疗慢性胰腺炎(CP)的疗效。方法回顾性分析我院2000年6月至2009年10月期间32例行Frey手术的CP患者临床资料,观察围手术期并发症发生率和疼痛缓解率,着重了解胰腺内、外分泌功能。结果 32例患者术后无死亡病例。围手术期并发症发生率为9.4%(3/32)。其中2例患者出现伤口脂肪液化,经对症处理后痊愈;1例患者术后第4天出现胰瘘,经禁食、营养支持治疗康复出院。住院时间(11±2)d。术后患者均获随访,随访时间平均43个月,16例(50.0%)患者疼痛完全消失,14例(43.8%)患者疼痛明显缓解,2例无效,术后疼痛缓解率为93.8%。5例糖尿病患者术后病情无加重,术后新发糖尿病患者3例。3例术前伴消化不良、脂肪泻患者中,1例术后口服胰酶制剂后症状缓解,2例无变化;新增脂肪泻患者4例。结论在严格掌握手术指证的前提下,采用Frey手术治疗CP是一种安全、有效的方法。Objective To explore clinical efficacy of Frey procedures for chronic pancreatitis.Methods Thirty two patients with chronic pancreatitis who underwent Frey procedures in our hospital from June 2000 to October 2009 were analyzed retrospectively.The rate of perioperative complications,pain relief,and especially endocrine and exocrine function of pancreas in long-term follow-up（mean 43 months） were analyzed.Results No death occurred in all patients.Fat liquefaction of wound was found in two patients and pancreatic fistula was found in one patient,who was cured by conventional treatment.So the rate of perioperative complications was 9.4%（3/32）.After Frey procedures,pain disappeared completely in sixteen patients（50.0%）,pain relieved in fourteen patients（43.8%） and two cases were ineffective.Therefore,the rate of pain relief in long-term follow-up was 93.8%.The hospitalization was（11±2） d.After surgical treatment the illness of five patients with diabetes mellitus did not aggravate while new onset of diabetes mellitus was observed in three cases.For three cases who suffered from indigestion and steatorrhea,symptomatic relief was found in one patient treated by oral administration of pancreatin and inefficacy was observed in two cases.But four patients with new steatorrhea were found after operation.Conclusion Under the strict surgical indications,Frey procedure is a safe and effective surgical method for the treatment of chronic pancreatitis.

关 键 词：慢性胰腺炎 Frey手术 围手术期并发症 胰腺内分泌功能 胰腺外分泌功能 疼痛缓解率 

分 类 号：R657.51[医药卫生—外科学]