本文選題：壞死 + 胰腺假囊腫　； 參考：《中華肝臟外科手術(shù)學(xué)電子雜志》2016年06期

【摘要】：目的探討腎鏡治療重癥急性胰腺炎包裹性壞死(WON)內(nèi)引流術(shù)后感染的應(yīng)用價(jià)值。方法回顧性分析2010年1月至2016年2月在中國人民解放軍總醫(yī)院5例將WON作為胰腺假性囊腫行內(nèi)引流術(shù)后引起胰腺感染性壞死患者臨床資料。其中男3例,女2例;年齡39~67歲,中位年齡47歲;2例行開腹內(nèi)引流術(shù),3例行胃鏡下穿刺置管內(nèi)引流術(shù)。術(shù)后均出現(xiàn)胰腺感染性壞死的典型臨床及影像學(xué)表現(xiàn)。所有患者均簽署知情同意書,符合醫(yī)學(xué)倫理學(xué)規(guī)定�；颊咝蠧T引導(dǎo)下經(jīng)皮穿刺置管引流術(shù)(PCD),經(jīng)皮腎鏡腹膜后入路胰周壞死組織清除術(shù),術(shù)后沖洗引流。結(jié)果 4例接受1次腎鏡治療,1例接受2次腎鏡治療,均治愈出院。術(shù)后住院時(shí)間15(7~32)d,無圍手術(shù)期死亡及術(shù)后并發(fā)癥發(fā)生。結(jié)論腎鏡治療手術(shù)創(chuàng)傷小,療效好,可作為WON被誤認(rèn)為胰腺假性囊腫行內(nèi)引流術(shù)后導(dǎo)致感染的最佳補(bǔ)救性治療手段。
[Abstract]:Objective to investigate the value of renal endoscopy in the treatment of severe acute pancreatitis (SAP) infection after intracerebral drainage. Methods from January 2010 to February 2016, the clinical data of 5 cases of pancreatic infectious necrosis caused by WON as pancreatic pseudocyst were analyzed retrospectively in the General Hospital of Chinese people's Liberation Army (PLA). Among them, 3 cases were male, 2 cases were female, the age was 3967 years old, the median age was 47 years old, 2 cases were treated with open abdominal drainage and 3 cases were treated by gastroscopic puncture and catheterization. The typical clinical and imaging manifestations of pancreatic infectious necrosis occurred after operation. All patients signed informed consent, in accordance with the provisions of medical ethics. The patients were treated with CT guided percutaneous catheterization and drainage, percutaneous nephroscopic retroperitoneal excision of peripancreatic necrotic tissue, and postoperative irrigation and drainage. Results 4 cases were treated with one nephroscope and 1 case received 2 times of renal endoscopy, all of them were cured and discharged. No perioperative death and postoperative complications occurred. Conclusion Nephroscopy is the best method for the treatment of pancreatic pseudocyst with less trauma and better curative effect. It can be regarded as the best remedy for the infection of pancreatic pseudocyst after internal drainage.
【作者單位】： 中國人民解放軍總醫(yī)院肝膽外科;
【分類號】：R657.51

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