重症急性胰腺炎相关性消化道瘘的发生与预防探讨

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目的:探讨重症急性胰腺炎(SAP)相关性消化道瘘的发生与预防.方法:回顾2000年1月-2012年1月收治的23例SAP并发消化道瘘患者的临床资料,分析SAP相关性消化道瘘的发生部位、发生时间,患者胰腺病变范围特点和并发消化道瘘与引流管置入情况.结果:全组23例患者中结肠瘘11例(47.8%),十二指肠瘘7例(30.4%),小肠瘘4例(17.4%),胃瘘1例(4.3%);消化道瘘多发生在SAP术后1~2周内;患者腺病变累及范围大,常累及胰头、十二指肠、结肠等;16例患者的消化道瘘与引流管放置有关.结论:SAP并发消化道瘘不仅与解剖因素、胰外炎症侵犯、手术创伤等相关,而且与SAP自然病程相关,预防消化道瘘还需从SAP的整体治疗来考虑.
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