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目的:探讨腹部手术后急性胰腺炎的病因、诊断和治疗。方法:回顾分析云南省第一人民医院急诊创伤外科2000年6月至2006年6月发生的腹部手术后急性胰腺炎12例。结果:12例术后急性胰腺炎发生于阑尾炎穿孔弥漫性腹膜炎术后7例、结肠癌梗阻右半结肠切除术后3例、胃穿孔修补术后2例。经抗炎、抑制胰液分泌、禁饮食、胃肠减压及胃管注入中药大承气汤等治疗,12例全部治愈。结论:术后急性胰腺炎的诊断除血尿淀粉酶升高外,必须结合腹痛、腹胀、血象升高及影像学改变进行诊断。其病因与手术创伤、感染、低血容量和饮食相关。治疗上须进行内科正规综合治疗。
Objective: To investigate the etiology, diagnosis and treatment of acute pancreatitis after abdominal surgery. Methods: A retrospective analysis of 12 cases of acute pancreatitis after abdominal surgery occurred in the Department of Emergency Traumatology, First People’s Hospital of Yunnan Province from June 2000 to June 2006. Results: Twelve cases of acute pancreatitis occurred in 7 cases after perforation perforation of diffuse appendicitis, 3 cases after right colon resection and 2 cases after gastric perforation. The anti-inflammatory, inhibition of pancreatic juice secretion, forbidden diet, gastrointestinal decompression and gastric tube injection Dachengqi Decoction treatment, 12 cases were cured. Conclusion: The diagnosis of acute pancreatitis should be combined with abdominal pain, abdominal distension, elevated blood and imaging changes in addition to hematuria amylase. The etiology and surgical trauma, infection, hypovolemia and diet related. The treatment should be conducted on the regular comprehensive treatment of internal medicine.