后腹腔镜胰腺坏死组织清除术治疗老年重症急性胰腺炎的效果

发布时间：2018-05-10 06:06

本文选题：重症急性胰腺炎 + 胰腺坏死组织清除术　；参考：《中国老年学杂志》2017年19期

【摘要】：目的对比观察经腹膜后入路腹腔镜下胰腺坏死组织清除术治疗老年重症急性胰腺炎的方法及临床效果。方法老年重症急性胰腺炎患者中22例经腹膜后入路腹腔镜下胰腺坏死组织清除术治疗为观察组,30例开腹胰腺坏死组织清除术治疗为对照组,观察分析两组一般资料、手术治疗方法、临床结局和并发症发生情况。结果两组手术均顺利完成,无术中死亡病例,观察组手术时间明显短于对照组,术中出血明显少于对照组,手术切口总长度明显短于对照组(均P0.05)。观察组在术后单器官衰竭、新发消化道瘘、切口疝、切口感染等并发症总发生率(22.7%)明显低于对照组(66.7%,χ~2=9.816,P0.05);观察组死亡率(13.6%)低于对照组(20.0%),但无统计学差异(χ~2=0.359,P0.05);观察组住院时间及住院费用明显低于对照组(P0.05)。结论后腹腔镜胰腺坏死组织清除术治疗老年重症急性胰腺炎效果显著,操作简单,术后并发症少,能够有效降低患者术后死亡率,患者住院时间短,花费低。
[Abstract]:Objective to observe the methods and clinical effects of retroperitoneal laparoscopic pancreatic necrotizing tissue removal in elderly patients with severe acute pancreatitis. Methods 22 elderly patients with severe acute pancreatitis were treated by retroperitoneal laparoscopic pancreatic necrotic tissue clearance. 30 cases of open abdominal pancreatic necrotic tissue removal were treated as control group. The general data of the two groups were observed and analyzed. Surgical treatment, clinical outcome and complications. Results the operation time of the observation group was shorter than that of the control group, the intraoperative bleeding was obviously less than that of the control group, and the total length of the operative incision was significantly shorter than that of the control group (all P 0.05). In the observation group, single organ failure, new gastrointestinal fistula and incisional hernia were observed after operation. The total incidence of complications such as incision infection was significantly lower than that of the control group (66.7%, 蠂 ~ 2 + 9.816) P 0.05, and the mortality rate of the observation group (13.6%) was lower than that of the control group (20.0%), but there was no statistical difference (蠂 ~ (2 + 2) 0.359 (P 0.05), the length of stay and the cost of hospitalization in the observation group were significantly lower than those in the control group (P 0.05). Conclusion Laparoscopic excision of pancreatic necrotic tissue in elderly patients with severe acute pancreatitis is effective, simple in operation and less in postoperative complications. It can effectively reduce the postoperative mortality rate, reduce the hospitalization time and cost less.
【作者单位】：昆明医科大学第二附属医院甲状腺乳腺外科;昆明医科大学第二附属医院急诊医学部急诊外科;
【分类号】：R657.51

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