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目的:研究急性重症胰腺炎坏死组织清除、小网膜囊灌洗术后的短、中期胰腺结构与功能变化。方法:回顾性分析10例急性重症(出血坏死性)胰腺炎患者的临床资料和术后随访期间的临床指标,所有患者接受腹部增强CT、逆行胰胆管镜造影(ERCP),测定口服葡萄糖耐量、大便排泄物脂肪及空腹血清C肽。结果:在随访期间无1例胰腺炎复发,3例检出术后糖尿病,无1例出现术后脂肪泻,5例病人腹部增强CT中发现有胰腺重度病变,ERCP提示有6例病人胰管损害较重,多数表现为主胰管中断。糖耐量测定中3例病人显示糖耐量异常,2例显示胰腺内分泌功能受损害。大便排泻物脂肪测定提示8例病人为异常结果。结论:中期随访结果显示急性重症胰腺炎和胰腺坏死组织清除与术后胰腺结构和功能的变化有一定关系。
Objective: To study the changes of short and mid-term pancreatic structure and function after tissue necrosis and severe retinal necrosis in severe acute pancreatitis. Methods: The clinical data of 10 patients with acute severe hemorrhagic necrotizing pancreatitis were retrospectively analyzed. All patients underwent abdominal enhanced CT and retrograde cholangiopancreatography (ERCP), and the oral glucose tolerance, Stool faecal fat and fasting serum C-peptide. Results: No recurrence of pancreatitis was found in the follow-up period, and postoperative diabetes was detected in 3 cases. No postoperative steatorrhea occurred in 1 case. Severe pancreatic lesions were found in 5 cases of abdomen enhanced CT, and 6 cases of pancreatic duct Damages heavier, the majority of the performance of the main pancreatic duct interrupt. Three patients with impaired glucose tolerance showed impaired glucose tolerance and two showed impaired endocrine function of the pancreas. Stool diarrhea fat determination tips 8 patients were abnormal results. Conclusion: The results of mid-term follow-up showed that acute pancreatitis and pancreatic necrotic tissue clearance have some relations with the changes of pancreatic structure and function.