CAJ | 학술논문

目的探讨重症急性胰腺炎(SAP)术后并发肠瘘的诊断和治疗.方法对1999年8月～2008年12月手术治疗的89例SAP进行回顾性分析,探讨可能导致肠瘘发生的危险因素及其诊断治疗.结果治疗的SAP发生肠瘘16例,其中结肠瘘10例,十二指肠瘘6例,均出现在术后两周内,有胰腺感染的较无感染的发生率高(P<0.05);早期手术较后期手术(>2周)发生率高(P<0.05).结论 SAP术后的肠瘘与胰外炎性浸润,手术创伤以及手术时机的选择有关.肠瘘的治疗应充分考虑原发病的状况,并根据肠瘘的位置、局部炎症的情况,早期通过加强营养支持,保持瘘口周围引流通畅,多数肠瘘可自行愈合,后期少数不愈合肠瘘和考虑手术治疗.
목적 탐토중증급성이선염(SAP)술후병발장루적진단화치료.방법 대1999년8월～2008년12월수술치료적89례SAP진행회고성분석,탐토가능도치장루발생적위험인소급기진단치료.결과 치료적SAP발생장루16례,기중결장루10례,십이지장루6례,균출현재술후량주내,유이선감염적교무감염적발생솔고(P<0.05);조기수술교후기수술(>2주)발생솔고(P<0.05).결론 SAP술후적장루여이외염성침윤,수술창상이급수술시궤적선택유관.장루적치료응충분고필원발병적상황,병근거장루적위치、국부염증적정황,조기통과가강영양지지,보지루구주위인류통창,다수장루가자행유합,후기소수불유합장루화고필수술치료.
Objective To investigate the diagnosis and treatment for the fistula complicated by severe acute panereatitis(SAP). Methods A retrospective analysis was made on 89 SAP eases admired from Aug. 1999 to Dec. 2008 in order to evaluate the risk factor of complicated fistula and surgical management. Results The fistula developed in 16 cases out of 89 case undergoing surgery, all were within 2 weeks postoperatious. The fistula developed more commonly in those with peripancreatic inflammatory infiltration than those without(P<0.05). The likelihood of fistula was larger in those undergoing surgery within 2 weeks than after 2 weeks of the onset of SAP(P<0.05). Conclusion The fistula after the operation of SAP is deeply related to peripancreatic inflammatory infiltration. The trauma of operation,the time and methods of operation. By using nutritional support and keeping drainage of fistula, most of the fistula can close up naturally. Just a few of fistula which can not close up should be operated in the later.