摘要
目的分析与总结胰十二指肠切除术后腹腔出血的原因、诊断及治疗策略。方法回顾性分析了2003年1月至2008年12月间开展的350例胰十二指肠切除术患者资料。结果在350例患者中,有12例出现术后腹腔出血,术后腹腔出血的发生率为3.4%,死亡率为16.7%;其中男性9例,女性3例,平均年龄(56.42±10.2)岁。7例因恶性疾病行胰十二指肠切除者术后发生腹腔出血,5例为良性疾病。术前伴有梗阻性黄疸者9例(75%),非黄疸者3例;与未出血组相比,出血组在术前黄疸、术中联合血管切除、良性疾病以及术后合并腹腔感染等四个方面存在差异显著。结论术前积极纠正机体异常情况,术中正确操作和术后发生出血时对其严重程度的准确判断和及时治疗是预防和处理术后腹腔出血的关键。
Objective To analyze the cause, diagnosis and treatment of postoperative intra-abdominal hemorrhage after pancreatoduodenectomy （PD）. Methods The medical records of 350 patients who had undergone pancreaticoduodenectomy between January 2003 and December 2008 were analyzed retrospectively with regard to postoperative intra-abdominal hemorrhage. Results Twelve patients with postoperative intra - abdominal hemorrhage after pancreatoduodenectomy were screened from 350 PD patients. The overall morbidity of hemorrahge was 16.7% , while the relative mortality was 3.4% in the intra-abdominal hemorrahge group. Compared with the non-hemorrahge group, preoperative jaundice, intraoperative combined resection of blood vessels, benign disease and postoperative intra-abdominal infection were independent risk factors for the postoperative intra-abdominal hemorrhage. Conclusions Postoperative intra-abdominal hemorrhage after pancreaticoduodenectomy is associated with a high mortality. Careful preoperative preparations, proper intraoperative manipulations and prompt decision and postoperative treatment of hemorrahge were crucial.
出处
《中华普外科手术学杂志（电子版）》
2009年第1期19-22,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胰十二指肠切除术
手术后出血
诊断
治疗学
Pancreatoduodenectomy
Postoperative hemorrahge
Diagnosis
Therapeutics
