区域性动脉灌注5－FU治疗急性坏死性胰腺炎

Local arterial infusion of 5-FU in treatment of acutenecrotic pancreatitis

作者自１９９２年８月至１９９３年１２月，无选择地对１９例急性坏死性胰腺炎患者采用Ｓｅｌｄｉｎｇｅｒ法，将Ｃｏｒｄｉｓ导管置于胰腺病变的供血动脉内。如坏死病变位于胰头部，导管置于胃十二指肠动脉或胰十二指肠动脉；坏死病变限于胰体尾部，导管置于脾动脉或腹腔动脉；全胰散在性坏死病变，置管于腹腔动脉。经导管内区域性灌注５－ＦＵ为主的药物，自发病起２０天内为灌注治疗时间。全组病例治疗后获得满意效果，并与以手术治疗为主的６８例作对照，结果两组死亡率分别为１０．５％、３０．９％；器官功能衰竭发生率分别为５．３％、４２．７％；继发性细菌感染发生率分别为５．３％、４４．１％；有显著差异。作者认为区域性动脉灌注５－ＦＵ治疗急性坏死性胰腺炎是一种有效的疗法，且给延期手术，清除残留坏死胰腺组织提供了基础，术后病情恢复平衡。文中对方法、时间、作用和体会均作了详细的阐述。

AbstractIn 19 patients with acute necrotic pancreatitis thecordis tube was inserted in the arterial suppling blood.If the necrotic site at the head of pancreata,the tubewas placed in the arteria gastroduodenalis or arteriapancreaticoduodenalis. When the site at the trunk orrearby,the tube was placed in the arteria lienalis orcoeliaca,and when the necrosis all over the pancreata,the tube in the arteria coeliaca. Through the tube,in-fusion drugs mainly 5-FU were given within 20 daysfrom onset of the disease. Compared with the con-trolled group of 68 patients,the mortalities were10.5%and 30.9%,and the rates of organ falls 5.3%and 42.7%. The second infection of bacterium was5.3%and 44.1%respectively;We suggest that localarterial infusion of 5-FU is an effective treatment foracute necrotic pancreatitis and creats conditions for de-layed operations,clears the remaining tissue of necrot-ic pancreatitis easily.