胃癌根治术后并发胰腺功能异常的临床研究

Pancreatic dysfunction after radical resection of advanced gastric cancer

目的探讨胃癌术后胰腺功能异常的临床特点及其诊治。方法对125例进展期胃癌根治术的术后生化指标行动态分析。结果术后急性胰腺炎发生率为0.7%,剥离胰腺被膜、游离胰腺组（胰腺操作组,n=14）中提示胰腺功能异常14例（100%）,胰腺未操作组（n=111）中指标异常病例18例（16.22%）。两组间血淀粉酶、腹腔引流淀粉酶及血钙均有显著差异。结论术后血淀粉酶、腹腔引流淀粉酶、血钙是评价胰腺功能异常的重要指标。胃癌术后胰腺损伤与普通胰腺炎比较有其独特性,掌握其特点是防治关键。

Objective To investigate the clinical features and management of pancreatic dysfunction following radical resection of gastric cancer. Methods A perspective study of 125 radical gastrectomies for malignancy was made, Third and the changes of postoperative biochemical indexwere obser ved. Results The morbidity of acute pancreatic dysfunction was 0.7%. There were 14 cases with dysfunction in stripping caps/isolating pancreas group （ 100% , n = 14） and 18 in non-touch group （ 16.22% , n = 111, P = 〈 0.05）. The hemodiastase, amylase of abdominal drainage and blood calcium were statistically significant these two groups. Conclusion Postoperative hemodiastase, amylase of abdominal drainage and blood calcium are important and index to evaluate the postoperative dysfunction of pancreas. Comparing with the profiles of acute pancreatitis, the characteristics of pancreatic injury after gastrectomy were unique, which should be recognized clearly and considered as a key point to prevent its development and improve its prognosis.