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胃癌根治术后急性胰腺炎的临床预防
引用本文:张伟兴,潘耀东. 胃癌根治术后急性胰腺炎的临床预防[J]. 河南外科学杂志, 2006, 12(1): 9-10
作者姓名:张伟兴  潘耀东
作者单位:江苏省常州肿瘤医院普外科,213001
摘    要:目的探讨胃癌根治术后急性胰腺炎的预防。方法对197例胃癌根治术后发生急性胰腺炎4例病人的临床资料进行分析。结果术后急性胰腺炎的发生率为2%。发病时间为术后1d~9d。表现为术后伤口和腹部持续疼痛,腹痛位置模糊,肠蠕动恢复障碍,心动过速、低血压,高热。实验室检查:WBC(1.2~2.0)×109/L,中性粒细胞0.82~0.95。非手术治疗4例,手术治疗1例,痊愈。结论术后切口和腹痛较剧,低血压,高热,胃肠蠕动恢复障碍是胃癌根治术后急性胰腺炎的临床特点。木中尽可能减少对胰腺的袭扰和损伤,置腹腔引流,慎用哌替啶镇痛,适当应用H2受体拮抗剂、生长抑素等有预防作用。

关 键 词:胃肿瘤  根治术  急性胰腺炎  并发症
收稿时间:2005-09-29
修稿时间:2005-09-29

THE CLINICAL PREVENTION OF ACUTE PANCREATITIS AFTER RADICAL GASTRECTOMY FOR GASTRIC CANCER
ZHANG Wei-xing,PAN Yao-dong. THE CLINICAL PREVENTION OF ACUTE PANCREATITIS AFTER RADICAL GASTRECTOMY FOR GASTRIC CANCER[J]. Henan JOurnal of Surgery, 2006, 12(1): 9-10
Authors:ZHANG Wei-xing  PAN Yao-dong
Affiliation:ZHANG Wei-xing,PAN Yao-dong.Department of General Surgery The Cancer Hospital ofChang Zhou,Chang Zhou 213001.China
Abstract:Objective To investigate the clinical prevention of postoperative acute pancreatitis following radical surgery for gastric cancer.Methods A review of 221 radical gastrectomies for carcinoma of the stomach was made,in which six patients were found to have acute pancreatitis.The clinical data of these six cases were analyzed.Results The attack rate of acute pancreatitis was 2%(4/197).They occurred at from 1~9days postoperatively.The manifestations were:pain in incision and increasing abdominal pain with obscure sites,failure of bowel movement,and tachycardia.as well as hypotension.remittent fever.White blood cell count above(1.2~2.0)×10~9/L neutrophil being 0.82~0.95.foure were treated in conservative way;one underwent surgery and recovered uneventfully.Conclusion postoperative incision and abdominal pain,disorder of bowel function are feature of acute pancreatitis following radical surgery for Gsastric carcinoma.Avoidance of rude manipulation and injury of pancreas during operation, abdominal drainage,carefull postoperative application of pethidine.proper use of H_2-recepter antagonist and somatostain are conducive to prevention of this complication.
Keywords:stomach - neoplasms radical- gastrectomy    acute pancreatitis    complications
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