重症急性胰腺炎术后腹腔大出血的临床分析

The clinical analysis of postoperative intraperitoneal massive hemorrhage in patients with severe acute pancreatitis.

目的 探讨重症急性胰腺炎(SAP)术后腹腔出血的特点及其诊断、治疗。方法 对1991～2001年间SAP及其胰周并发症手术治疗、术后发生腹腔大出血的13例SAP病人进行回顾性分析。结果 SAP术后腹腔出血主要以胰床及其周围的渗血及小血管破裂为多,时间多在手术后5～20天内发生。出血部位的局部压迫止血是早期抢救的有效措施之一,介入放射学对诊断和治疗都有积极意义。结论 SAP术后腹腔出血的死亡率高,一旦发生应及时、准确地判断并予以处理,以期改善病人的预后。

Objective To explore feature, diagnosis and treatment of postoperative intraperitoneal massive hemorrhage in patients with severe acute pancreatitis (SAP). Methods From 1991 -2001, 13 cases with postoperative intraperitoneal massive bleeding due to operative treatment of SAP and peri-pancreatic complications were analvzed retrospectivelv. Results In the intraperitoneal bleeding after operation of SAP, the oozing and disruption of small blood vessels in the pancreas and peri-pancreatic region was most common cause . The bleeding time usuallv occured on 5 th to 20 th day postoperatively. Local pressing hemostasis in the bleeding site was one of the effective method of early rescue. Interventional radiology to diagnosis and treatment had active significance. Conclusion The mortality is very high in the intraperitoneal bleeding of after operation of SAP. For improving the patients prognosis, a correct jugement and management are very important as soon as intraperitoneal massive bleeding occurs.