胰腺假性囊肿两种内引流术的对比研究

发布时间：2018-06-15 03:00

本文选题：胰腺假性囊肿 + 分型　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:本研究通过对我院胰腺假性囊肿(pancreatic pseudocyst,PPC)的两种内引流术式的临床效果进行探讨,对比两种内引流术式的优劣。资料及方法:2011.3-2015.7兰州大学第一医院收治的56例PPC行内引流术的患者分为囊肿-空肠Roux-en-Y吻合术组(A组)、囊肿-胃吻合术组(B组)。其中A组35例,B组21例。统计一般信息、治疗方法、术中出血量、术后并发症、术后通气时间、进食时间、住院时间、复发等数据,所有病例随访6-18个月(平均12.8月),对比两组手术方法的优劣。结果:A组手术时间(2.96±0.13h)长于B组(1.96±0.11h,P0.05);A组术中出血量(361.57±8.97ml)多于B组(292.38±18.88ml,P0.05);术后消化道出血A组2例(5.7%),B组6例(28.6%),差异有统计学意义(P0.05);A组囊肿无复发,B组复发1例(4.8%),两组差异无统计学意义(P0.05);A组术后胰瘘、感染发生率分别为5.7%(2/35)、0%,B组分别为0%,4.8%(1/21),两组差异无统计学意义(P0.05);术后通气时间、进食时间、术后住院时间A组分别为3.54±0.65d、4.74±0.74d、6.60±0.65d,B组为3.71±0.78d、4.44±0.87d、6.38±0.80d,两组差异无显著性(P0.05)。结论:囊肿胃吻合术操作简单,手术时间短,术中出血量较少,但术后消化道出血较多见;囊肿空肠Roux-en-Y吻合术手术时间长,术中出血量较多,但消化道出血较少见,且对囊肿的位置没有特殊要求。两种方法各有利弊,因此对不同的病例,应合理选择手术方法。
[Abstract]:Objective: to investigate the clinical effects of two internal drainage methods of pancreatic pseudocystoma PPCs in our hospital and compare the advantages and disadvantages of the two internal drainage methods. Materials and methods 56 patients with PPC undergoing internal drainage were divided into two groups: cyst-jejunum Roux-en-Y anastomosis group (group A) and cyst-gastrostomy group (group B). There were 35 cases in group A and 21 cases in group B. Statistics of general information, treatment methods, intraoperative bleeding volume, postoperative complications, postoperative ventilation time, feeding time, hospitalization time, recurrence and other data, all cases were followed up for 6-18 months (mean 12.8 months), compared the advantages and disadvantages of the two groups. Results the operative time of group A (2.96 卤0.13 h) was longer than that of group B (1.96 卤0.11hP0.05ml) than group A (361.57 卤8.97ml), and that of group A was 292.38 卤18.88ml (P0.05), and that of group A was 2 cases of postoperative gastrointestinal hemorrhage (group A, 2 cases: 5.72ml, group B, 6 cases), there was significant difference between group A (group A), group B (n = 1), and group B (n = 1). There was no significant difference between the two groups in the recurrence of cysts in group B and group B (n = 1). In group A, pancreatic fistula was found after operation. The incidence of infection in group B was 3.71 卤0.78 卤0.87 卤6.38 卤0.80 days, respectively. There was no significant difference between the two groups (P 0.05), the time of postoperative ventilation, the time of feeding and the time of hospitalization after operation were 3.54 卤0.65 days, 4.74 卤0.74 days and 6.60 卤0.65 days, respectively. The rates of infection in group B were 3.71 卤0.78 days, 4.44 卤0.87 days and 6.38 卤0.80 days, respectively. There was no significant difference between the two groups (P 0.05). Conclusion: the operation of cyst-stomach anastomosis is simple, the operation time is short, the amount of intraoperative bleeding is less, but the postoperative gastrointestinal hemorrhage is more common, the cyst-jejunostomy Roux-en-Y anastomosis has a long operation time, the amount of intraoperative bleeding is more, but the bleeding of digestive tract is rare. There is no special requirement for the location of the cyst. The two methods have their advantages and disadvantages, so for different cases, we should choose the operative method reasonably.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.5

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