胆石性重症胰腺炎的治疗对策及疗效分析

目的　探讨胆石性重症胰腺炎 (GSP)的合理治疗方法和疗效。方法　回顾性分析治疗的97例GSP临床资料。结果　 97例中 ,重症I级 5 4例 ,II级 43例 ;治愈 77例 ( 79.4% ) ,病死 2 0例( 2 0 .6% )。内镜治疗组 (EST)、延期手术组和早期手术组的并发率分别为 2 4.1% ,2 5 .0 %和 65 .5 % ;病死率分别为 10 .3 % ,13 .9%和 3 7.5 % ,前两组均明显低于早期手术组 (P <0 .0 5 )。结论　GSP治疗应根据“个体化方案” ,无胆石梗阻者应延期手术 ;有胆石嵌顿梗阻者应及早施行EST治疗或开腹手术 ,对重症II级患者首选EST治疗

Analysis of therapeutic strategy and effectiveness of therapy for severe gallstone pancreatitis

Objective To investigate a rational treatment for severe gallstone pancreatitis(SGP) and evaluate therapeutic effect.Methods A retrospective study was made on the clinical data of 97 cases with SGP.(Results) Among 97 SGP patients,54 cases were in severe grade I, 43 cases were Grade II;77(79.4%) cases were cured and 20(20.6%)died.The morbidity rates of endoscopic therapy(EST),delayed surgery and early surgery were 24.1%,25.0% and 65.5% respecticely,while the mortality rates in the 3 groups were 10.3%,13.9% and 37.5% respectively.The morbidity and morality rates in the first 2 groups were significanty lower than the early surgery group(P<0.05).Conclusions The treatment of SGP should be taken individually.Patients without gallstone obstruction should undergo delayed surgery;those with obstruction by impacted gallstone should undergo early EST or laparotomy;for severe garde II patients,EST is the first choice of treatment.