摘要
作者总结４年来治疗急性出血坏死性胰腺炎（ＡＨＮＰ）７０例的经验。胆源性３９例，非胆源性３９例。早期简化手术治疗１４例，非手术治疗５６例，其中中转手术１１例，手术距发病时间９～９０天，中转手术原因：坏死组织感染５例，无菌性坏死性包块引起胆道及胃肠道梗阻２例，大量胰性腹水１例，巨大假性囊肿１例，假性囊肿破裂出血２例。１１例中行坏死组织清除及外引流７例（其中３例采用多个小切口），囊肿内引流１例，囊肿外引流２例，单纯腹腔置管引流腹水１例；术后腹腔感染９例，消化道瘘１例，胰瘘６例。全组死亡３例，死亡率为４．３％。早期手术指征为诊断不明及伴有严重胆管炎；中转手术指征为：（１）坏死组织继发不可控性感染；（２）无菌性坏死性包块出现并发症；（３）胰腺假性囊肿及其并发症；（４）大量腹水经保守治疗不能控制；（５）胆源性坏死性胰腺炎治愈后应择期行胆道手术；（６）坏死性胰腺炎原因不明。
Abstract In recent 4 years, 70 cases of acute necrotizing pancreatitis were admited into our service. Early simple operation was performed in 14 case under indication of undefinited diagnosis or severe cholangitis. Late exploration was performed in 56 conservatively treated cases for (1)intractable infection secondary to pancreatic necrosis; (2)necrotic pancreatic mass; (3) pseudocyst and; (4) intractable ascites,Mortality rate was. 4. 3%.
出处
《普外临床》
CSCD
1996年第4期250-251,253,共3页
