胰十二指肠切除术后早期主要并发症的原因分析
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陈梅福E-mail:chen_meifu@126.com

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Clinical analysis on the main early postoperative complications of pancreatoduodenectomy
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    摘要:

    目的:总结胰十二指肠切除术后早期的主要并发症并分析其可能原因。
    方法:回顾性分析1990年2月—2009年5月因壶腹部恶性肿瘤实施的576例胰十二指肠切除术后患者的临床资料。
    结果:术后85例(14.8%)患者发生早期并发症92例次,其中以胃肠道功能障碍、胰漏、腹腔感染以及术后出血最多见;围手术期死亡7例(病死率1.22%),其中3例死于多系统器官功能衰竭,2例死于失血性休克,2例死于感染性休克。危险因素分析显示,术前低蛋白、高胆红素血症与术后高并发症发生率相关。
    结论:术前细致准备,术中精细操作,术后加强观察,是降低术后早期并发症,改善PD术后患者预后的关键。

    Abstract:

    Objective:To summarize the main early complications after pancreatoduodenectomy and analysis of the probable causes.
    Methods: The clinical data of 576 cases who underwent pancreatoduodenectomy (PD) in our department between Feb 1990 and May 2009 were analysed retrospectively.
    Results:There were 92 early postoperative complications occurred in 85 patients(14.8%). Gastrointestinal dysfunction, pancreatic leakage, intra-abdominal infections and hemorrhage were the most of complications, and 7 cases died during perioperative period(mortality 1.22%), among which 3 died of multiple system organ failure, 2 died of hemorrhagic shock and 2 died of toxic shock. Preoperative hypoproteinemia and hyperbilirubinemia complicated with a high incidence of postoperative complications on multivariate analysis.
    Conclusions:Meticulous preoperative preparation,delicate intraoperative technigne and close postoperative observation are the key points to decrease early complications and improve the prognosis of the patients who undergo PD.

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陈梅福, 陈晚平, 欧晔, 吴金术.胰十二指肠切除术后早期主要并发症的原因分析[J].中国普通外科杂志,2009,18(12):1284-1287.
DOI:10.7659/j. issn.1005-6947.2009.12.014

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  • 收稿日期:2009-08-04
  • 最后修改日期:2009-11-17
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  • 在线发布日期: 2009-12-15