重症急性胰腺炎严重并发症的预防

目的　探讨重症急性胰腺炎 (SAP)并发症的原因和预防。方法　回顾性分析 16 5例SAP的诊治情况 ,并分为三个阶段比较各阶段并发症发生与病情危重程度、手术与否和手术方式、时机之间的关系。结果　三个阶段并发症发生率分别为 72 .0 % (36 / 5 0 )、6 4 .6 % (31/ 4 8)和 34.2 % (2 3/6 7)。早期手术组、延期手术组和非手术组的并发症发生率分别为 6 2 .5 %、5 8.7%和 34.7%。结论　胰腺坏死和病情的严重程度、治疗不当是引起并发症的重要原因 ,早期不必要的手术介入会增加其发生。以非手术为主的ICU重症监护治疗 ,及正确选择手术指征、时机和方式可减少或预防其发生

Prevention of severe complications in severe acute pancreatitis

Objective To explore the causes and prevention for severe complications in severe acute pancreatitis (SAP).Methods Clinical data and treatment of 165 cases of SAP were analyzed retrospectively. On the principles of treatment 3 periods were allocated. The incidence of complications, surgical treatment or not, and the operative opportunities and modes were compared, respectively.Results Severe complications occurred in 90 cases of SAP with the incidence of complications at 3 periods being 72.0% , 64.6% and 34.2% , respectively. The incidence of complications in the groups of early surgery, the deferred surgery and non-operation was 62.5% , 58.7% and 34.5% , respectively.Conclusions The severity of the pancreatic necrosis and illness in SAP were the main causes for the complications. The methods for the patients to receive the normalized treatment primarily by means of non-operation and choose the correct indications, and the opportunity and mode of surgery could decrease or prevent them.