重症急性胰腺炎术后合并上消化道大出血16例临床分析

MANAGEMENT OF GASTROINESTINAL MASSIVE BLEEDING IN THE POSTOPERATIVE PATIENTS WITH SEVERE ACUTE PANCREATITIS (SAP) REPORT OF 16 CASES

目的 探讨急症急性胰腺炎 ( SAP)术后并发上消化道大出血的因素及预防治疗措施。方法 回顾分析 1985年10月～ 2 0 0 0年 12月本院收治经外科治疗 SAP术后发生消化道大出血 16例相关因素及治疗方法。结果 本组 SAP术后发生消化道大出血 16例 ,(其中胆源性胰腺炎 9例 ) ,均采用非手术治疗。上消化道大出血合并多脏器功能衰竭死亡 7例 ;合并胰腺脓肿 ,脓毒血症死亡 1例 ;余治愈。结论 老年 SAP尤其是胆源性胰腺炎患者 ,术后容易发生胃粘膜病变 ,导致上消化道大出血。

Objective To investigate gastroinestinal massive bleeding in postoperative severe acute pancreatitis (SAP) and explore the effectiveness of measures for its prevention and treatment.Methods Clinical data of 16 patients with SAP in our center from October 1985 to December 2000,were retrospectively analized.Results The incidence of gastintestinal massives bleeding in the SAP occurred in 16 cases (9 cases biliogenic SAP).ALL patients receive nonoperative therapy.7 cases with multiple organ failure (MOF) and 1 case with pancreatic abscess pyosepticemia died.Conclusion Gastrointestinal massive beelding often occurred in elderly SAP of postoperative patients, esphecially those of biliogenic SAP.The early use of gastritic mucous barrier of protective measure is very important for the SAP of patients