优先解剖肠系膜上动脉在胰十二指肠切除术中的临床应用  

Clinical application of anterograde anatomical superior mesenteric artery first in pancreaticoduodenectomy

作　　者：陈冬 龚昭[1] 曾志武[1] 杨光耀[1] 夏辉[1] 周程[1] 朱鹏[1] CHEN Dong;GONG Zhao;ZENG Zhiwu(Department of Hepatobiliary Surgery,Wuhan No 1 Hospital,Wuhan 430022 China)

机构地区：[1]武汉市第一医院肝胆外科,430022

出　　处：《临床外科杂志》2020年第4期344-346,共3页Journal of Clinical Surgery

基　　金：武汉市科技局应用基础研究计划项目(2017060201010183);武汉市卫生计生科研基金资助项目(WX17B04)。

摘　　要：目的探讨优先解剖肠系膜上动脉(SMA)技术在胰十二指肠切除术(PD)中的临床应用。方法 2012年1月~2017年12月行PD病人60例,根据手术方法不同将60例病人分为两组,研究组30例,采用优先解剖SMA技术;对照组30例,未采用优先解剖SMA技术,比较两组病人手术情况。结果研究组病人手术时间为(382.1±63.9)分钟、住院时间(14.6±1.2)天、ICU时间(2.3±0.8)天、术中出血量(190.2±192.0)ml、输血率26.7%(8/30),对照组分别为(443.6±49.2)分钟、住院时间(18.4±2.0)天、ICU时间(4.9±0.8)天、术中出血量(373.0±362.6)ml、输血率66.7%(20/30),两组比较差异有统计学意义(P<0.05)。结论优先解剖SMA技术能明显缩短肿瘤侵及肠系膜上静脉的PD的手术时间、住院时间及ICU时间,并能减少术中出血量,降低输血率。Objective To explore the clinical application of anterograde mesenteric artery(SMA)technique first in pancreaticoduodenectomy(PD).Methods The clinical data of 146 cases of PD patients in our hospital in January 2012~2017 December were analyzed retrospectively.According to the inclusion criteria,the clinical data of 60 patients were further analyzed,and 2 groups were divided:the study group(n=30):anterograde anatomy of SMA first;the control group(n=30):no anterograde anatomy of SMA first was used.Results The study patients’ operation time(382.1±63.9)min,time of hospitalization(14.6±1.2)d,ICU time(2.3±0.8)d,intraoperative bleeding(190.2±192.0)ml,blood transfusion rate 8(26.7%) were significantly lower than those of the control group,which were(443.6±49.2)min,(18.4±2.0)d,(4.9±0.8)d,(373.0±362.6)ml,66.7%(20/30),respectively(P<0.05).Conclusion Anatomic SMA first technique can significantly shorten the operation time,time of hospitalization and ICU time for tumor invasion of the superior mesenteric vein,and reduce the amount of bleeding,blood transfusion rate.

关 键 词：肠系膜上动脉 胰十二指肠切除术 

分 类 号：R656[医药卫生—外科学]