中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
17期
1159-1161
,共3页
王利新%符伟国%郭大乔%徐欣%陈斌%蒋俊豪%杨珏%史振宇%竺挺%石赟%董智慧%唐骁%李炜淼%王玉琦
王利新%符偉國%郭大喬%徐訢%陳斌%蔣俊豪%楊玨%史振宇%竺挺%石赟%董智慧%唐驍%李煒淼%王玉琦
왕리신%부위국%곽대교%서흔%진빈%장준호%양각%사진우%축정%석빈%동지혜%당효%리위묘%왕옥기
对比剂%胰腺炎%血管造影%腔内治疗
對比劑%胰腺炎%血管造影%腔內治療
대비제%이선염%혈관조영%강내치료
Contrast medium%Pancreatitis%Angiography%Endovascular therapy
目的 探讨血管造影和腔内治疗过程中对比剂所致胰腺炎的原因及治疗方法.方法 回顾性分析上海中山医院血管外科2000年12月至2010年1月10年来进行血管造影和腔内治疗后发生对比剂所致胰腺炎的病例.记录伴存疾病、发生胰腺炎的时间、胰腺炎的特点、治疗的手段和预后;查找相关的文献,结合病例特点,分析对比剂所致胰腺炎可能的原因、对比剂所致胰腺炎的特点、治疗特殊之处及预后.结果 10年共发生对比剂所致胰腺炎3例.1例为青年男性,因肾动脉狭窄行肾动脉造影,术后出现腹痛,检查证实为水肿型胰腺炎,经药物治疗后痊愈.1例为老年男性,因肾动脉狭窄、腹主动脉瘤行肾动脉和腹主动脉造影,术中出现腹痛,检查证实为水肿型胰腺炎,经药物治疗后缓解,治疗过程中因突发心梗而死亡.1例为老年女性,因腹主动脉瘤术后内漏行腔内修复术,术后出现持续性腹胀,诊断为水肿性胰腺炎,经药物治疗后缓解不明显,后因多器官功能衰竭而死亡.结论 对比剂所致胰腺炎总的发病率较低,不易早期发现.早期诊断与治疗是提高治疗效果的关键,伴存疾病较多者治疗效果不佳.
目的 探討血管造影和腔內治療過程中對比劑所緻胰腺炎的原因及治療方法.方法 迴顧性分析上海中山醫院血管外科2000年12月至2010年1月10年來進行血管造影和腔內治療後髮生對比劑所緻胰腺炎的病例.記錄伴存疾病、髮生胰腺炎的時間、胰腺炎的特點、治療的手段和預後;查找相關的文獻,結閤病例特點,分析對比劑所緻胰腺炎可能的原因、對比劑所緻胰腺炎的特點、治療特殊之處及預後.結果 10年共髮生對比劑所緻胰腺炎3例.1例為青年男性,因腎動脈狹窄行腎動脈造影,術後齣現腹痛,檢查證實為水腫型胰腺炎,經藥物治療後痊愈.1例為老年男性,因腎動脈狹窄、腹主動脈瘤行腎動脈和腹主動脈造影,術中齣現腹痛,檢查證實為水腫型胰腺炎,經藥物治療後緩解,治療過程中因突髮心梗而死亡.1例為老年女性,因腹主動脈瘤術後內漏行腔內脩複術,術後齣現持續性腹脹,診斷為水腫性胰腺炎,經藥物治療後緩解不明顯,後因多器官功能衰竭而死亡.結論 對比劑所緻胰腺炎總的髮病率較低,不易早期髮現.早期診斷與治療是提高治療效果的關鍵,伴存疾病較多者治療效果不佳.
목적 탐토혈관조영화강내치료과정중대비제소치이선염적원인급치료방법.방법 회고성분석상해중산의원혈관외과2000년12월지2010년1월10년래진행혈관조영화강내치료후발생대비제소치이선염적병례.기록반존질병、발생이선염적시간、이선염적특점、치료적수단화예후;사조상관적문헌,결합병례특점,분석대비제소치이선염가능적원인、대비제소치이선염적특점、치료특수지처급예후.결과 10년공발생대비제소치이선염3례.1례위청년남성,인신동맥협착행신동맥조영,술후출현복통,검사증실위수종형이선염,경약물치료후전유.1례위노년남성,인신동맥협착、복주동맥류행신동맥화복주동맥조영,술중출현복통,검사증실위수종형이선염,경약물치료후완해,치료과정중인돌발심경이사망.1례위노년녀성,인복주동맥류술후내루행강내수복술,술후출현지속성복창,진단위수종성이선염,경약물치료후완해불명현,후인다기관공능쇠갈이사망.결론 대비제소치이선염총적발병솔교저,불역조기발현.조기진단여치료시제고치료효과적관건,반존질병교다자치료효과불가.
Objective To report the contrast medium induced pancreatitis after angiography or endovascular therapy, analyze the possible cause of this complication, the treatment specialty and the prognosis. Method The patients suffered from contrast medium induced pancreatitis after angiography or endovascular therapy during last 10 years were retrospectively analyzed. The patients' comorbidity, the onset time of the pancreatitis, the specialty of the pancreatitis, the treatment method and the prognosis were documented. The relative literature was retrieved and reviewed. The clinical data was compared with the relative literature and analyzed. Results Three cases of contrast medium induced pancreatitis were documented. One case was a young man, received angiography because of renal artery stenosis. He was suffered from moderate abdominal pain 2 hours after the procedure. Pancreatitis of edema type was confirmed by CT scan. He recovered thoroughly after the medical treatment. One case was an old man, underwent angiography for renal artery stenosis and abdominal aortic aneurysm. He was suffered from acute abdominal pain during the procedure. The CT scan revealed as edema pancreatitis. He died from cardiac infarction during the treatment. The last case was an old female, suffered from sustained abdominal distension after endovascular treatment of endoleak post AAA EVAR. Edema pancreatitis was confirmed by CT scan. The symptom was not alleviated well after the treatment. Finally she was died from MOSF. Conclusion The incidence of contrast medium induced pancreatitis is relatively low. It's not easy to detect in early stage.Early diagnosis and treatment is the key to improve the therapeutic effect. The prognosis of patient with multiple comorbidity is poor.
