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目的对胰十二指肠切除手术后胰瘘并发症的原因与预防措施进行探讨。方法对我院2008年6月至2012年5月实施的30例胰十二指肠切除术患者的临床资料进行回顾分析,结合其中的胰瘘并发症患者案例进行了影响因素与原因的分析,并对胰瘘并发症的预控措施进行了总结。结果胰十二指肠切除术中的胰瘘并发症与手术实施中的吻合技术密切关系,且患者自身的胰腺硬度、手术对胰腺残留断面的处理、患者胰管直径大小等都可影响胰瘘并发症的发生;而对胰腺进行胰管支撑性引流能够有效预防胰瘘并发症的发生。结论进行胰瘘并发症的有效预防需要完善胰管支撑引流与吻合技术,并在切除术中与术后做好胰腺切面供血护理,才能切实做好胰瘘并发预防。
Objective To investigate the causes and preventive measures of complications of pancreatic fistula after pancreatoduodenectomy. Methods The clinical data of 30 patients with pancreatoduodenectomy performed in our hospital from June 2008 to May 2012 were retrospectively analyzed and the influencing factors and causes were analyzed in combination with the cases of patients with pancreatic fistula complication. The pre-control measures of pancreatic fistula complications were summarized. Results Pancreatic fistula complication in pancreatoduodenectomy was closely related to the anastomosis technique in operation, and the patient’s own pancreatic firmness, surgical treatment of the residual section of the pancreas and the diameter of the pancreatic duct of the patient all influenced the pancreatic fistula Complications occurred; while the pancreatic duct drainage for pancreatic drainage can effectively prevent the occurrence of complications of pancreatic fistula. Conclusion The effective prevention of complications of pancreatic fistula need to improve the drainage and anastomosis of pancreatic duct support, and in the resection and postoperative pancreatic surface blood supply care, in order to effectively do a good pancreatic fistula concurrent prevention.