胰腺炎并发假性动脉瘤11例临床分析

目的分析判断胰腺假性动脉瘤适合的临床诊断及治疗方法。方法回顾我院2006年1月至2014年12月间收治的11例胰腺假性动脉瘤患者临床资料，包括诊断、治疗方式及临床效果。结果胰腺假性动脉瘤的诊断方式为经内镜超声诊断2例，经腹部增强CT诊断8例，经介入造影诊断1例。10例患者接受经动脉介入栓塞治疗，9例治疗成功，随访28 d时，1例患者再次出血，经二次栓塞治疗成功止血；1例患者成功接受手术治疗。结论腹部增强CT及动脉造影是诊断胰腺假性动脉瘤的主要方法，内镜超声也可用于诊断。手术治疗是胰腺假性动脉瘤的传统治疗方式，介入栓塞治疗逐渐成为治疗胰腺假性动脉瘤的首选治疗方式。但为进一步明确胰腺假性动脉瘤的诊疗方案，仍需大样本的临床观察。

Diagnosis and treatment of pseudoaneurysm complicated with pancreatitis

ObjectiveTo analyze the diagnosis treatment and methods for pancreatic pseudoaneurysms complicated with pancreatitis. MethodsThe diagnostic methods,treatments and clinical effects of 11 patients with pancreatic pseudoaneurysms complicated with pancreatitis from January 2006 to December 2014 were retrospectively analyzed in Shengjing hospital. ResultsTwo cases of pancreatic pseudoaneurysms were diagnosed by endoscopic ultrasonography(EUS). Eight cases were diagnosed with contrast-enhanced computed tomography. One case was diagnosed by angiography. Ten patients received endovascular embolization, and nine of them were successfully treated. Rebleeding occurred in one patient 28 days after embolization, and was successfully treated by repeated embolization. One patient was successfully treated by surgery. ConclusionContrast-enhanced computed tomography and angiography are the current main methods to diagnose pancreatic pseudoaneurysms. With the wide use of EUS in the diagnosis of pancreatic disease, EUS becomes an option for diagnosis of pancreatic pseudoaneurysm. Traditionally, pancreatic pseudoaneurysm is treated by surgery. With the advancement of endovascular techniques, endovascular treatment has become the first-line treatment. Further studies with a large sample size are needed to establish the better diagnostic methods and treatments for pancreatic pseudoaneurysm.