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AIM To evaluate the usefulness of ultrasound monitoring acute fluid accumulation in acute pancreatitis.METHODS Six hunclred and twenty-seven patients with acute pancreatitis were undergone ultrasonographicexamination. All examinations were performed by the attending doctors. The first scans were performed onthe first or second day after admission to our hospital, if there were acute fluid accumulation inperipancreatic spaces including the lesser sac, pararenalspaces, peritoneal cavity, or even thoracic cavity,then the follow-up scans were routinely performed 3 - 7 days following the initial scan and this interval wasdependent upon the severity of acute pancreatitis, and partieulanly noticed the changes of pancreas and thefluid mentioned above. Continuous variables were analyzed by t test, Discrete variables were analyzed by the,x2 test and rank sum test using SPSS, P<0.05 was considered significant.RESULTS Acute fluid accumulation was fouad in 57.5% of 627 patients among them 14.4% evolved intocomplications and 85.6% resolved spontaneously. The most frequent sites of fluid accumulation are theperitoneal cavity and the left hemithorax, followed by the lesser sac and right hemithorax (x2 = 738,P<0.0001); the hospital stay was longer as the quantity of acute fluid accumulation increased (P<0.0001, t = 2.2 - 4.2 ). There was no fluid accumulation in mild AP and more than 2 sites in severe AP (P<0.0001, x2 = 147.8).CONCLUSION The number of sites as well as the duration of fluid accumulation are proportional tohospital stay and the severity of AP.
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胰液空肠回注治疗大量胰瘘一例体会及文献复习
1.病例介绍:天津大港医院外二科2006年收治一例严重多发伤病人,该病人胃及十二指肠多处断裂,胰腺断裂,因合并严重头胸四肢外伤,故为其腹部行胃大部切除,十二指肠修补,胃空肠吻合,胰腺一期缝合,胰腺上下引流,空肠距离吻合口30 cm置窄肠营养管治疗.
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先天性胆道扩张症动物模型的制作——P-Ch吻合术的实践与结果
作者从事先天性胆道扩张症的病因学研究,采用日本学者大川氏的手术方法成功地制造了狗的动物模型,并进行了有关X线学、生化学、病理学的研究.本文还就本症病因学研究的各种方法进行了讨论.
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胆管扩张症的病因研究——胆汁内胰酶的观察与分析
本文通过对囊型及梭型肚管扩张症患儿胆汁内胰酶的研究.获得了囊型与梭型扩张胆汁内胰酶差异的认识.梭型扩张组胰蛋白酶含量明显高于囊型扩张组(P<0.01).且梭型扩张组淀粉酶与胰蛋白酶含量成正相关关系(r=0.874).我们认为胆总管扩张的程度和类型主要取决于返流胰酶的激活量.
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胆总管囊肿内引流术晚期并发症处理
我科于1974年前共收治23例胆总管囊肿,除2例囊肿空肠Roux-Y吻合术外,余21例皆行囊肿十二指肠吻合术.术后随诊15例,5例表现有程度不同的胆管炎症状,其中1例再次手术;1例于术后2年出现上消化道出血,诊断门静脉高压症.