胰管空肠黏膜吻合和胰肠套入式吻合对胰十二指肠切除术后胰瘘对照研究.docVIP

胰管空肠黏膜吻合和胰肠套入式吻合对胰十二指肠切除术后胰瘘对照研究 　　[摘要] 目的 胰管空肠黏膜吻合与胰肠套入式吻合对胰十二指肠切除术后胰瘘对照研究。方法 随机选取该院及中山大学孙逸仙医院收治的2013年1月―2015年1月80例胰十二指肠切除术患者，并且随机数字表分配方法，分为研究组（40例）、对照组（40例）。给予对照组患者临床中，应用胰肠套入式吻合，研究组中患者，采取胰管空肠黏膜吻合，对比两组患者临床手术后患者有无发生胰瘘。结果 对于研究组中患者，临床十二指肠切除术中经胰管空肠黏膜吻合，改良临床术后疗效，在患者手术时间、术后住院日、MAP数据方面，分别为（3.28±1.63）h、（20.0±11.33）d、（12.28±0.26）mmHg；对照组在其手术时间、术后住院日、MAP方面，分别为（5.38±1.33）h、（30.0±10.33）d、（8.35±1.51）mmHg，两组对比差异有统计学意义（P0.05）；同时，临床针对胰十二指肠切除患者，采取胰管空肠黏膜吻合与胰肠套入式吻合，还有助于降低胰瘘发病率，研究组胰瘘发生率为5.0%，对照组胰瘘发生率为20.0%，与对照组对比其差异有统计意义（P0.05）。结论 在临床胰十二指肠切除术患者中，应用胰管空肠黏膜吻合，相较于胰肠套入式吻合可以改善临床疗效，降低术后胰瘘发病率，发挥积极应用疗效。 　　[关键词] 胰十二指肠切除术；胰肠套入式吻合；胰瘘；胰管空肠黏膜吻合 　　[中图分类号] R657.5 [文献标识码] A [文章编号] 1674-0742（2015）11（b）-0046-03 　　[Abstract] Objective To randomizedly and controlledly study duct-to-mucosa pancreaticojejunostomy versus invaginated pancreaticoenterostomy in the treatment of pancreatic fistula after duodenopancreatectomy. Methods 80 cases underwent duodenopancreatectomy in Sun Yat-sen Memorial Hospital， Sun Yat-sen University from January 2013 to January 2015 were randomly selected and divided into the study group and the control group with 40 cases in each according to the random number table allocation method. Patients in the control group were treated by the invaginated pancreaticoenterostomy， and those in the study group were treated by the duct-to-mucosa pancreaticojejunostomy. And the postoperative incidence of pancreatic fistula of the two groups was compared. Results The operation time， postoperative hospital stay， MAP was （3.28±1.63）h， （20.0±11.33）d， （12.28±0.26）mmHg respectively in the study group， and that was （5.38±1.33）h， （30.0±10.33）d， （8.35±1.51）mmHg respectively in the control group， the differences in the above data between the two groups were statistically significant（P0.05）. Duct-to-mucosa pancreaticojejunostomy and invaginated pancreaticoenterostomy in duodenopancreatectomy were conducive to reducing the incidence of pancreatic fistula after duodenopancreatectomy. The incidence of pa