本文選題：胰十二指腸切除術(shù) + 胰管支撐管　； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景胰十二指腸切除術(shù)是腹部外科最復(fù)雜、風(fēng)險(xiǎn)最高的手術(shù)之一,術(shù)后并發(fā)癥發(fā)生率高,其中胰瘺是最常見和最嚴(yán)重的術(shù)后并發(fā)癥。對(duì)于在胰腸吻合的過程中,在胰管內(nèi)置入支撐管將胰液外引流是否能減少胰瘺的發(fā)生率,目前國(guó)內(nèi)外存在廣泛的爭(zhēng)議,相關(guān)的隨機(jī)對(duì)照試驗(yàn)研究也較少。目的評(píng)價(jià)不同胰腸吻合方式在胰十二指腸切除術(shù)中的臨床療效,探討不放置胰管支撐管的胰腸吻合的適用性。方法我院自2012年1月至2015年12月收治的87例可行胰十二指腸切除術(shù)患者,按隨機(jī)分配方式分為胰管-空腸黏膜對(duì)黏膜端側(cè)吻合+胰管支撐管外引流組(A組,43例)和胰腺-空腸端側(cè)吻合不放置胰管支撐管組(B組,44例),比較兩種不同胰腸吻合方式行胰腸吻合術(shù)的時(shí)間及術(shù)后住院時(shí)間、術(shù)后并發(fā)癥的發(fā)生率。結(jié)果術(shù)中未放入胰管支撐管組的胰腸吻合時(shí)間(平均15.4min)明顯小于術(shù)中放入胰管支撐管組(平均21.1min),差異有統(tǒng)計(jì)學(xué)意義(t=7.137,P0.05)。B組患者術(shù)后住院時(shí)間小于A組(t=2.408,P0.05,差異有統(tǒng)計(jì)學(xué)意義)。兩組患者術(shù)后胰瘺、腹腔出血、腹腔感染、胃潴留,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.181,0.322,0.603,0.001;P0.05)。結(jié)論胰十二指腸切除術(shù)不放置胰管支撐管可減少手術(shù)時(shí)間,降低術(shù)后住院天數(shù),且術(shù)后并發(fā)癥的發(fā)生率無顯著差異,是安全可靠的。
[Abstract]:Background pancreaticoduodenectomy is one of the most complex and high-risk operations in abdominal surgery. The incidence of postoperative complications is high. Pancreatic fistula is the most common and severe postoperative complication. In the process of pancreaticojejunostomy, whether the drainage of pancreatic juice can reduce the incidence of pancreatic fistula by inserting a supporting tube into the pancreatic duct is widely disputed at home and abroad, and there are few related randomized controlled trials at home and abroad. Objective to evaluate the clinical effect of different pancreaticojejunostomy in pancreaticoduodenectomy and to explore the applicability of pancreaticojejunostomy without pancreatic duct supporting tube. Methods from January 2012 to December 2015, 87 cases of feasible pancreaticoduodenectomy were treated in our hospital. According to the random distribution pattern, the pancreatic duct and jejunum mucosa were divided into two groups: pancreatic duct end-to-side anastomosis group (group A, 43 cases) and pancreatic jejunal end-to-side anastomosis group (group B, 44 cases). Two different types of pancreaticojejunostomy were compared. The time of pancreaticojejunostomy and the time of hospitalization, Incidence of postoperative complications. Results the mean time of pancreaticojejunostomy (15.4min) in group B was significantly shorter than that in group A (mean 21.1min), and the difference was statistically significant (P 0.05). The postoperative hospitalization time in group B was less than that in group A (t = 2.408, P 0.05, P < 0.05). There was no significant difference in postoperative pancreatic fistula, abdominal hemorrhage, abdominal infection and gastric retention between the two groups (蠂 ~ 2 0.181 ~ 0.322 ~ 0.603 ~ 0. 001P 0.05). Conclusion it is safe and reliable for the pancreaticoduodenectomy not to place the pancreatic duct supporting tube to reduce the operation time and the hospital stay after operation, and there is no significant difference in the incidence of postoperative complications.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R656

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