摘要
目的:对比分析腹腔镜治疗感染性与无菌性胰腺包裹性坏死(WON)的治疗效果及生存质量。方法:回顾分析2015年2月至2019年3月为38例感染性WON(感染组,n=17)与有临床症状的无菌性WON(症状组,n=21)患者行腹腔镜囊肿胃吻合术联合坏死组织清除术的临床资料。分析手术效果,随访并评估患者生存质量。结果:手术时间平均(155.00±29.96)min,术中失血量平均(50.26±25.36)mL,13例(34%)患者同时行胆囊切除术。术后总体死亡率5.26%。两组手术时间、术中失血量差异无统计学意义,但感染组住院时间长于症状组(P<0.01),住院费用高于症状组(P=0.01),更多的患者需要重症护理(P=0.02),随访中感染组有更多的患者出现胰腺内外分泌功能障碍(P<0.05)。结论:感染性WON的预后较无菌性WON差,但通过微创手术可获得良好的治疗结果。
Objective:To compare and analyze the efficacy and quality of life of laparoscopy in the treatment of infected and symptomatic sterile walled-off pancreatic necrosis(WON).Methods:The clinical data of 38 patients of WON who underwent laparoscopic cyst gastrostomy and necrosectomy from Feb.2015 to Mar.2019 were retrospectively analyzed.Of the 38 cases,17 were infected WON(infected group) and 21 were symptomatic sterile(symptomatic group).The effects of surgery were analyzed and compared,the quality of life was followed up and evaluated.Results:Operation time in both groups was(155.00±29.96)min,intraoperative blood loss was(50.26±25.36)mL.13 patients(34%) underwent concomitant cholecystectomy.The overall mortality rate was 5.26%.There were no significant differences between the two groups in operation time and intraoperative blood loss.Compared with symptomatic group,infected group was associated with longer hospital stay(P<0.01),higher hospitalization costs(P=0.01),more patients needed intensive care(P=0.02),and more patients developed pancreatic endocrine and exocrine insufficiency during follow-up(P<0.05).Conclusions:Infected WON has worse prognosis than sterile WON,but can achieve good therapeutic outcome using minimally invasive operation.
作者
党军强
任彦顺
杨栓元
张志强
龚新利
王浩瑜
DANG Jun-qiang;REN Yan-shun;YANG Shuan-yuan(Department of Hepatobiliary Pancreatic and Splenic Surgery,People's Hospital of Tongchuan,Tongchuan 727031,China)
出处
《腹腔镜外科杂志》
2021年第2期93-96,共4页
Journal of Laparoscopic Surgery
基金
铜川市卫生和计划生育局项目(2018C008)。
