肾镜治疗重症急性胰腺炎包裹性坏死内引流术后感染

发布时间：2018-05-18 05:53

本文选题：坏死 + 胰腺假囊肿　；参考：《中华肝脏外科手术学电子杂志》2016年06期

【摘要】：目的探讨肾镜治疗重症急性胰腺炎包裹性坏死(WON)内引流术后感染的应用价值。方法回顾性分析2010年1月至2016年2月在中国人民解放军总医院5例将WON作为胰腺假性囊肿行内引流术后引起胰腺感染性坏死患者临床资料。其中男3例,女2例;年龄39~67岁,中位年龄47岁;2例行开腹内引流术,3例行胃镜下穿刺置管内引流术。术后均出现胰腺感染性坏死的典型临床及影像学表现。所有患者均签署知情同意书,符合医学伦理学规定。患者行CT引导下经皮穿刺置管引流术(PCD),经皮肾镜腹膜后入路胰周坏死组织清除术,术后冲洗引流。结果 4例接受1次肾镜治疗,1例接受2次肾镜治疗,均治愈出院。术后住院时间15(7~32)d,无围手术期死亡及术后并发症发生。结论肾镜治疗手术创伤小,疗效好,可作为WON被误认为胰腺假性囊肿行内引流术后导致感染的最佳补救性治疗手段。
[Abstract]:Objective to investigate the value of renal endoscopy in the treatment of severe acute pancreatitis (SAP) infection after intracerebral drainage. Methods from January 2010 to February 2016, the clinical data of 5 cases of pancreatic infectious necrosis caused by WON as pancreatic pseudocyst were analyzed retrospectively in the General Hospital of Chinese people's Liberation Army (PLA). Among them, 3 cases were male, 2 cases were female, the age was 3967 years old, the median age was 47 years old, 2 cases were treated with open abdominal drainage and 3 cases were treated by gastroscopic puncture and catheterization. The typical clinical and imaging manifestations of pancreatic infectious necrosis occurred after operation. All patients signed informed consent, in accordance with the provisions of medical ethics. The patients were treated with CT guided percutaneous catheterization and drainage, percutaneous nephroscopic retroperitoneal excision of peripancreatic necrotic tissue, and postoperative irrigation and drainage. Results 4 cases were treated with one nephroscope and 1 case received 2 times of renal endoscopy, all of them were cured and discharged. No perioperative death and postoperative complications occurred. Conclusion Nephroscopy is the best method for the treatment of pancreatic pseudocyst with less trauma and better curative effect. It can be regarded as the best remedy for the infection of pancreatic pseudocyst after internal drainage.
【作者单位】：中国人民解放军总医院肝胆外科;
【分类号】：R657.51

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