胃癌术后并发胰腺炎的诊治体会

Diagnosis and treatment of pancreatitis after operation for gastric carcinoma

目的探讨分析胃癌术后并发胰腺炎的诊断与治疗。方法回顾性分析我院2006年1月至2012年1月收治的31例患者胃癌术后诊断为急性胰腺炎,分析所有患者的治疗经过以及诊断、治疗过程。结果胃癌D2根治术患者的急性胰腺炎和SAP发生率分别为2.65%和0.66%,均明显低于D3根治术患者的12.58%和4.64%,而31例并发急性胰腺炎患者保守治疗的总有效率为95.24%,明显高于对照组的60.00%,D3术式下毕Ⅱ切除和全胃切除急性胰腺炎发生率均高于毕Ⅰ切除和近端胃切除,差异均具有统计学意义(P<0.05)。结论临床胃癌术后并发胰腺炎的诊断需要与患者手术损伤程度相结合,密切观察患者各项生命体征从而做出及时诊断,治疗上以保守治疗为主。

Objective To investigate the diagnosis and treatment of pancreatitis after gastric cancer surgery. Methods 31 cases of gastric cancer patients admitted to our hospital from January 2006 to January 2012 were diagnosed as acute pancreatitis after gastric cancer surgery, and the process of diagnosis and teatment of all the patients were retrospectively analysed. Results Acute pancreatitis and SAP incidence of D2 radical resection patients were 2.65% and 0.66% which were significantly lower than 12.58% and 4.64% of D3 radical surgery patients. The total effective rate of conservative treatment was 95.24% , which was significantly higher than 60.00% of the control group, and the differences were statistically significant （ P 〈 0.05 ）. Conclusion The clinical diagnosis of postoperative pancreatitis requires consideration of the injury degree of patients and close observation of the vital signs in order to make timely diagnosis. The way of treatment is given priority to conservative therapy.