摘要
目的 提高对胰性腹水的认识和诊治水平。方法 回顾性总结 10例胰性腹水的临床资料 ,结合文献分析胰性腹水的病因、诊断及治疗。结果 10例中 8例有慢性胰腺炎的证据 ,3例伴胰腺假性囊肿 ,5例有大量饮酒史 ;病史及临床表现多样 ,全部病例均有腹水淀粉酶升高 ,7例腹水蛋白显著升高 ;4例非手术治疗成功 ,1例因合并内科严重并发症死亡 ,5例行手术治疗。手术包括腹腔置管引流 ( 2例 ) ,胰尾及脾切除、胰空肠吻合 ( 1例 ) ,囊肿空肠吻合 ( 1例 ) ,单纯胰尾及脾切除 ( 1例 )。平均随访 7.2个月 ,无一例复发。结论 胰性腹水罕见 ,多有慢性胰腺炎史 ,临床表现多样 ,诊断主要依靠病史及腹水检查 ;非手术治疗可使部分病人痊愈 ,正规治疗 2～ 3周如无效应及时手术。
Objective To discuss diagnosis and treatment of pancreatic ascites.Methods The clinical datas of 10 cases suffering from pancreatic ascites were reviewed.Results The levels of amylase in the aspirated fluid were consistently elevated (>1000 units·l -1 ),along with the level of proteins (>3 g·dl -1 ),and on this basis the diagnosis was made.One patient died from serious complications related with internal medicine disease.In 4 patients conservative treatment was successful,and the remaining 5 patients required surgical treatment.Surgical intervention included abdominal cavity drainage,pancreaticojejunostomy with resection of the pancreas tail,pancreatic cystojejunostomy,and simple resection of the pancreas tail with splenectomy.With follow-up of 1 month to 32 months (mean follow-up time was 7.2 months),no recurrence was observed.Conclusions With a low incidence,pancreatic ascites occurs in association with the rupture of a pseudocyst or the disruption of a pancreatic duct during the natural course of chronic pancreatitis and which should be treated initially conservatively.If this is not effective,operative therapy should be considered as an alternative without delay.
出处
《临床外科杂志》
2003年第6期374-376,共3页
Journal of Clinical Surgery
关键词
胰性腹水
诊断
治疗
pancreatic ascites
diagnosis
therapy
