急性坏死性胰腺炎胰供血动脉改变的观察

目的通过观察胰供血动脉的形态改变,探讨胰腺血管损害程度与急性坏死性胰腺炎(ANP)病情严重程度、合并症及预后的关系.方法采用Seldinger法经股动脉插管至腹腔动脉后行数字式减影血管造影,根据胰腺血管损害的数目和程度,结合临床资料进行分析.结果本组69例中40例(58%)胰腺供血动脉显示截枝、未显影、粗细不均等异常改变,29例(42%)胰腺血管无异常改变.两组的病情严重程度、合并症及预后等有明显差异(P＜0.05).结论(1)胰腺血管损害致胰腺供血不足、组织缺血缺氧是胰腺出血、坏死的重要原因.(2)胰腺血管损害的数目和程度与ANP病情严重程度、合并症及病死率呈正相关.(3)疏通胰腺供血动脉和改善胰腺的血液循环,是ANP综合治疗中的重要一环.

Changes of pancreatic blood supply in acute necrotic pancreatitis

Objective To explore the relationship between t he pancreatic vascular abnormalities and pancreatic lesions, complications and pro gnosis in acute necrotic pancreatitis (ANP).Methods Seldinger procedure, DSA angiography was carried out in ANP pa tients to evaluate the alterations of pancreatic blood vessel, results were anal yzed against clinical data.Results In 40 out of 69 cases, the pancreatic blood supply showed abnormal in angiogram, t here were features of interuption, stenosis and complete obstruction. The degree of lesions and complications showed statistically significant correlation ( P<0.05).Conclusions (1)Blood s upply insufficiency is responsible for the hemorrhage and necrosis of pancreas.( 2)The number and degree of injuried pancreatic vessels were in positive correlat ion with the severity, complications and mortality of acute necrotic pancreatiti s.(3)Improving the blood supply to the pancreas greatly ameliorated the severity of ANP.