胰十二指肠切除术后出血的治疗策略
摘要
胰十二指肠切除术（pancreaticoduodenectomy，PD）具有手术复杂、涉及器官多及并发症发生率高等特点。随着手术技术的提升及围手术期处理方法的进步，近年来PD的病死率已降至5%以下，但仍有3%～10%的患者发生PD术后出血（postpancreatomy hemorrhage，PPH），相较于胰漏、腹腔内感染及胃排空障碍等常见并发症， PPH则更为凶险，病死率高达20%～50%，且诊断与治疗流程尚未有定论[1-2]。本文旨在讨论PPH常见原因及其诊断与治疗策略。
出处
《浙江医学》
CAS
2014年第20期1668-1670,1673,共4页
Zhejiang Medical Journal
参考文献19
-
1Roulin D, Ceranlola Y , Demartines N, et al. Systematic review ofdelayed posloperative hemorrhage after pancreatic resectionfJ] .JCastrointest Surg , 2011 , 15(6) : 1055-1062.
-
2Miura F, Asano T, Amano H, et al. Management of postoperativearterial hemorrhage after pancreato-biliary surgery according tothe site of bleeding: re-laparoLumy or interventional radiology[J].J Hepatobiliary Pane reaL Surg , 2009 , 16 (1) :56-63.
-
3Wente MN , Veit JA , Bassi C , et al. Postpancreate.clomy hemor-rhage (PPH) : an International Study Group of PancreaticSurgery (ISCPS) definirion [J]. Surgery,2007 ,142(1) : 20-25.
-
4Yekebas E F, Wolfram L. Cataidegirmen G, et al.Postpancreate-ctomy hemorrhage: diagnosis and treatment: an analysis in 1669consecutive pancreatic resections[J]. Ann Surg, 2007, 246(2):269-280.
-
5Rumstadt B. Schwab M, Korth P, et al. Hemorrhage after pancre-atoduodenectomy[J]. Ann Surg, 1998,227 (2) :236-241 .
-
6Song W,Yuan Y, Peng J, et al. The delayed massive hemorrhageafter gastrectomy Jn patients with gastric cancer: Characteristics,management opinions and risk factors [J/OL] . Eur I Surg Oncol,2014 [2014-04-03] .http ://www.sciencedirect. com/science/ar-ticle/pii/S0748798314003850.
-
7Wei H K, Wang S E. Shyr Y M. et al. Risk factors for post-pancre-aticoduodenectomy bleeding and finding an innovative approachto trealment[J] .Dig Surg , 2009 ,26 (4): 297-305 .
-
8Yamashita Y , Taketomi A. Fukuzawa K, et al. Risk factors for andmanagement of delayed intrape「丨coneal hemorrhage after pan-creatic and biliary surgery [J]. Am J Surg, 2007,193 ⑷:454-459.
-
9Tien Y W , Lee P H , Yang C Y , et al. Risk factors of massivebleeding related to pancreatic leak after pancreaticoduodenec-tomy[J] . J Am Coll Surg,2005 ,201 (4) :554-559.
-
10Limongelii P, Khorsandi S E, Pai M, et al. Manageme.nt of de-layed postoperative hemorrhage after pancreaticoduodenecto-my :ameta-analysis[J]. Arch Surg ,2008,143(10): 1001-1007 .
-
1苗毅,林士波,高文涛.胰十二指肠切除术后出血的治疗策略[J].中华外科杂志,2014,52(9):647-650. 被引量：5
-
2齐生伟,郑永波,徐振辕,贺占青,李永涛.胰十二指肠切除术后出血的防治[J].白求恩军医学院学报,2012,10(3).
-
3闵兴明,杨胜云,伍学才.阴茎管状皮肤前列腺窝移植在耻骨上前列腺切除术中的应用(附58例报告)[J].泸州医学院学报,2000,23(6):488-489.
-
4陈功,周晓庆,黄建才,赵士晖.医源性胆管损伤18例报告[J].中国基层医药,2008,15(1):129-129.
-
5曹锋,王亚军,李非.胰十二指肠切除术后出血的处理[J].中华普通外科杂志,2008,23(10):809-811. 被引量：2
-
6蔡华,吴金术.胰十二指肠切除术后出血的护理[J].医学临床研究,2009,26(11):2177-2179. 被引量：2
-
7邢人伟,牟永华,牟一平.胰十二指肠切除术后出血的原因及处理[J].肝胆胰外科杂志,2007,19(6):407-409. 被引量：2
-
8张秋学,刘汝海,王铁功,张磊,杨冬山,李凤山.胰十二指肠切除术后出血25例分析[J].中华普通外科杂志,2013,28(1):56-57. 被引量：3
-
9顾钧,吴文广,丁琦晨,杨佳华,李茂岚,张林,陆建华,董平,毕建威,刘颖斌.胰十二指肠切除术后出血的危险因素及其诊治[J].中国普外基础与临床杂志,2012,19(6):653-656. 被引量：28
-
10谭小荣,宗明,张永杰.胰十二指肠切除术后出血28例分析[J].人民军医,2012,55(3):245-246. 被引量：2
