继发性胰腺感染的诊治(附6例报告)

THE DIAGNOSIS AND MANAGEMENT OF SECONDARY PANCREATIC INFECTION

继发性胰腺感染是急性出血性坏死性胰腺炎最常见的严重并发症,其死亡率高,诊断困难,治疗棘手,是外科临床的疑难课题。本文报告近4年收治的6例,占同期急性胰腺炎134例的4.48％,占出血性胰腺炎15例的40％。全组6例在诊断后及时施行胰腺坏死组织清创和腹腔持续开放引流术,有的病例视病情需要反复清创。治疗结果3例死亡,占50％。本文对继发性胰腺感染的发病率、致病原因、发病机理、诊断和治疗进行了分析讨论。

Secondary pancreatic infection (SPI) is a serious complication of acute hemorrhagic necrotic pancreatitis. It's high mortality, difficult to diagnose and manage is the difficut problem in surgical clinic. 6 cases of SPI in recent 4 years we have had hospitalized up to now. In the same period there are 134 cases of acute pancreatitis and among which 15 cases are hemorrhagic necrotic type. Therefore, the incidence of SPI is 4.48% and 40% respectively compared with them. After diagnosis, debridment of necrotic tissue of the pancreas and persisting abdominal open drianage performed in all the 6 cases, 3 cases died. The mortality is 50%. The incidence, causes, prognosis, diagnosis and management of SPI are disscused.