重症急性胰腺炎的手术与非手术治疗

为提高重症急性胰腺炎（ＳＡＰ）的疗效，作者总结了９３例ＳＡＰ患者的治疗经验。９３例中，治愈７３例（７８．５％）、死亡２０例（２１．５％）。手术治疗组５３例，死亡１５例（２８．３％）；非手术治疗组４０例，死亡５例（１２．５％）。１９９２年以前早期手术为主，死亡率２３％；１９９２年以后非手术或延期手术为主，死亡率１９．５％。作者认为本病的死亡原因与病情、胰腺坏死范围、有无继发感染及器官衰竭的处理方法有关。早期手术未能改善初期休克、胰腺广泛坏死、器官衰竭等并发症的预后，而非手术方法可以治愈大多数ＳＡＰ病例。胰腺组织坏死继发严重感染者应行手术治疗。手术方法以坏死组织清除和充分引流为主。

Operative and non-operative treatment of acute severe pancreatitis

This study reports 93 patients of acute severe pancreatitis(ASP)with 73 patients(78.5%) healed and 20 patients (21.5%)died.Fifteen (28.3%)died in 53 patients undergoing operation, and 5 patients (12.5%)died in 40 patients who were treated conservatively.The early operation can not reduce the risk of slock,widely pancreatic necrosis and multiple organ failure.Most of the ASP patients can be cured without operation.The succendent pancreatic necrosis,spvere peripancreatic infection need surgical therapy,the surgery should be aimed at the debridement of necrotic tissues and full drainage.