摘要
目的 探讨重症胰腺炎并发结肠瘘的原因及诊治对策 ,提高重症胰腺炎的治愈率。方法 对 1 991年 1月～ 2 0 0 2年 1月我院收治的重症胰腺炎引流术后并发结肠瘘的 1 4例患者进行回顾性分析 ,了解其发生的危险性因素、发生部位及时间 ,并对早期诊断及采取的治疗方法进行总结。结果 结肠瘘多发生术后 4～ 6周内 ,本组治愈 1 3例 ,治愈率达到 93% (1 3/ 1 4 ) ,1例因严重全身感染和继发多脏器功能衰竭而死亡。结论 重症胰腺炎并发结肠瘘与解剖因素、局部炎症的程度、置管的方法和治疗措施等相关。采用双套管积极引流和空肠造瘘管的早期营养灌注或行结肠造瘘 。
Objective To investigate the causes and measurement of the colonic fistulas after severe acute pancreatitis(SAP),so as to increase its cure rate.Methods A retrospective study was made on 14 SAP cases complicated with colonic fistulas after drainage operation to find out the risk factors,the location and the time of complicated colonic fistulas,and to sum up the experiences of earlier diagnosis and comprehensive treatment.Results Most patients occurred colonic fistulas within 4～6 weeks postoperation.Thirteen patients recovered,the cure rate was 93%(13/14),and one died of serious systemtic infection and multiple organ systemtic failure.Conclusion Colonic fistulas complicated by SAP is related to anatomic factors,the degree of local inflammation,the way of draingic tube putted away,and improper surgical therapy.Comprehensive therapy including taking double cannula to drainage in active,earlier jejunostomy nutrition support or colostomy,supplementing with recombinant human growth hormone can lead to good results. [
出处
《中华急诊医学杂志》
CAS
CSCD
2003年第5期328-329,共2页
Chinese Journal of Emergency Medicine
