中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (09): 1-542.

• 论蓍 •    下一篇

胰十二指肠切除术中医源性动脉损伤的处理和预防

彭承宏 程东峰 沈柏用 杨卫平 陶宗元 丁家增 李宏为   

  1. 上海第二医科大学附属瑞金医院器官移植中心 上海消化外科研究所(200025)
  • 收稿日期:2005-06-18 修回日期:2005-07-18 出版日期:2005-09-20 发布日期:2005-09-20

  • Received:2005-06-18 Revised:2005-07-18 Online:2005-09-20 Published:2005-09-20

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摘要：

目的 探讨胰十二指肠切除术中医源性动脉损伤的处理和预防策略。方法 回顾性分析2001年1月至2005年4月5例医源性重要动脉损伤及其处理情况。结果 总体恢复顺利，但医源性动脉损伤明显增加术中出血量(P=00302)，明显延长手术时间(P=0076)和住院天数(P=00080)，显著增加医疗费用(P=00040)。结论 胰十二指肠切除术中医源性动脉损伤的预防远远重于治疗；对已发生的医源性动脉损伤术中正确处理是关键，切忌盲目钳夹，以免造成或扩大动脉损伤以至于无法弥补；损伤动脉的修复首先要确保动脉修复后内膜面的光整和血流通畅。

Abstract:

The treatment and prevention of the iatrogenic arterial injury in Pancreaticoduodenectomy. Peng Chenghong,Cheng Dongfeng,Shen Baiyong,et al.Center of the Organ Transplantation and Department of Surgery,Shanghai Institute of Digestive Surgery,Ruijin Hospital,Shanghai Second Medical University,Shanghai 200025,China Abstract Objective To explore the causes,prevention and treatment of iatrogenic arterial injury in Pancreaticoduodenectomy. Methods The clinical data of 5 cases of iatrogenic were retrospectively analyzed. Results All patients recovered uneventfully.After iatrogenic arterial injury,the bleeding volume increased signifcantly (P=00302),the operative time (P=00076) and the days of hospitalization(P=00080) were delayed obviously,and the medical expenses increased significantly (P=00040). Conclusion The prevention of the iatrogenic arterial injury is more important than the treatment.The correct treatment in operation after iatrogenic arterial injury is the key to avoid aggravating the arterial injury.Surgical repair should firstly insure the inner membrane of the injured artery to be smooth and straightway.