出血坏死性胰腺炎12例诊治体会

本文通过对12例出血坏死性胰腺炎(HNP)的临床诊治,指出在诊断上应注重根据症状、体征及病情变化进行推理,结合腹穿和腹水淀粉酶值测定等做出诊断和病情判断。主张对HNP采取以早期手术为主的综合治疗原则;原则上手术宜简不宜繁,建立彻底、通畅引流,必要时切除受损大网膜,不主张进行常规“三造瘘”;在手术治疗同时辅以综合性的治疗措施。

EXPERIENCE OF DIAGNOSING AND TREATING HNP IN 12 PATIENTS

The experiences of our clinical diagnosis and treatment for 12 patients with HNP indicate:the tress of diagnosis should be laid on the inference made from the symptoms, the body signs and changes in condition of patient and which must be combined with analysing the nature of ascitic fluid obtained by abdominocentesis and measuring the activity of ascitic amylase for making diagnosis and judging the degree of a change in this disease correctly; the main principle of treatment is to adopt early operations and to take comprehensive therapeutic measures as supplementary at the same time; operative procedure should not be complicated but simple, the first of these is building up a thorough and clear drainage and eliminating products of tissue necrosis; If it is necessary the injured ome ntum majus should be removed and the operation, "three fistulas", as usual is not advocated.