CAJ | 학술논문

目的分析远端胃癌根治术后迟发性腹腔出血的病因、诊断及治疗方案.方法对广州市第一人民医院2008年1月-2013年6月远端胃癌根治术后发生出血的45例患者进行回顾性研究.结果 45例患者中有13例发生迟发性腹腔性出血,出血时间为术后1～4周.其中5例为术后1周以后出现间歇性出血,经CT、DSA诊断为胃十二指肠动脉假性动脉瘤破裂出血,经DSA栓塞止血后治愈;8例术后3～4周出现反复呕血,经胃镜检查后明确诊断为吻合溃疡出血,在内镜下止血成功.结论远端胃癌根治术后迟发性腹腔出血病因复杂,CT、DSA及胃镜检查可帮助明确诊断,DSA及内镜具有较高的治疗价值,可避免再次开腹手术.
목적 분석원단위암근치술후지발성복강출혈적병인、진단급치료방안.방법 대엄주시제일인민의원2008년1월-2013년6월원단위암근치술후발생출혈적45례환자진행회고성연구.결과 45례환자중유13례발생지발성복강성출혈,출혈시간위술후1～4주.기중5례위술후1주이후출현간헐성출혈,경CT、DSA진단위위십이지장동맥가성동맥류파렬출혈,경DSA전새지혈후치유;8례술후3～4주출현반복구혈,경위경검사후명학진단위문합궤양출혈,재내경하지혈성공.결론 원단위암근치술후지발성복강출혈병인복잡,CT、DSA급위경검사가방조명학진단,DSA급내경구유교고적치료개치,가피면재차개복수술.
Objective Analyse the causes,diagnosis and treatment for delayed hemorrhage after distal radical gastrectomy.Methods Retrospective study on 45 patients combined with intro-abdominal hemorrhage after distal radical gastrectomy from January 2008 to June 2013.Results Thirteen patients combined with delayed hemorrhage in these 45 patients,all of 13 patients had intro-abdominal hemorrhage in 1week to 4 weeks after operation.And 5 of the 13 patiens were intermittent intro-abdominal hemorrhage 1 week after operation,these patients were demonstrated the blood come from gastroduodenal artery pseudoaneurysm fracture by CT and DSA examine,and they were cured by interventional embolization.Other 8 patients were marginal ulcer hemorrhage diagnosed by gastroscope,and they stoped bleeding with the help of gastroscope.Conclusions The causes of delayed hemorrhage after distal radical gastrectomy were complicated,and CT,DSA and endoscope can use for diagnosis.What was more,interventional embolization and endoscope were helpful for curing the intro-abdominal hemorrhage,avoiding re-operation.