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[使用区域动脉内灌注治疗和预防胰腺坏死的感染形式及并发症]

[Treatment and prophylaxis of infected forms and complications of pancreatic necrosis with the use of regional intraarterial infusion].

作者信息

Lubianskiĭ V G, Karpenko A A, Kuznetsov G L, Vlasov K E, Iatsyn A M

出版信息

Vestn Khir Im I I Grek. 2003;162(5):69-74.

Abstract

The aim of the investigation was to study the variants of the course of sterile and infected pancreatonecrosis, the character of the developing complications depending on the state of organic blood circulation in the pancreas and the influence of its correction upon the outcomes of the disease. The material of examination and treatment of 121 patients with pancreatonecrosis was analyzed. Complex treatment of 51 of the patients included the method of regional intraarterial infusion. Celiacography and CT with the intraarterial contrast reinforcement have revealed that in 35 (68.6%) patients there were symptoms of "perfusion block" of the pancreas of different degrees which was due to spasm, thrombosis of the vessels and impairment of the regional microcirculation. Differentiated approach to the composition of the infusate resulted in arrest of phenomena of "perfusion block" of the pancreas in 24 out of 35 patients. As a whole, using this method allowed to reduce the number of purulent complications, primary open operations and reoperations. Lethality in the group with infusion was 9.8%.

摘要

该研究的目的是探讨无菌性和感染性胰腺坏死病程的变异情况、取决于胰腺内有机血液循环状态的并发症发生特点以及对其进行纠正对疾病转归的影响。分析了121例胰腺坏死患者的检查和治疗资料。51例患者的综合治疗包括区域动脉内灌注法。腹腔动脉造影和动脉内造影增强CT显示,35例(68.6%)患者存在不同程度的胰腺“灌注阻滞”症状,这是由血管痉挛、血栓形成和局部微循环障碍所致。对输注液成分采用差异化方法,使35例患者中的24例胰腺“灌注阻滞”现象得到缓解。总体而言,使用该方法可减少化脓性并发症、初次开放性手术和再次手术的数量。采用灌注治疗组的死亡率为9.8%。

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