重症急性胰腺炎的评估与手术时机选择

目的 探讨应用（APACHE—Ⅱ）评估重症急性胰腺炎的意义和手术时机及疗效。方法 回顾分析2002年1月-2006年7月我科收治疗的86例重症急性胰腺炎患者的临床资料。结果 54例重症急性胰腺炎患者非手术治疗，死亡5例。32例手术治疗，死亡3例。手术组的危重程度（APACHE—Ⅱ）评分明显高于非手术组，但是2组的死亡率无明显差异。结论 多数重症急性胰腺炎可以非手术方式治愈。正确掌握手术时机和合理的手术方式、采用个体化综合治疗措施，可以提高重症急性胰腺炎患者的存活率。

Evaluation of severe acute pancreatitis and choice of operation time

Objective To inquire into the significance of severe acute pancreatitis evaluation by APACHE-II and the choice of operation time. Methods Clinical data of 86 cases with severe acute pancreatitis in our emergency department from January 2002 to July 2006 were retrospectively studied. Results 54 cases were treated by non-operation methods and 5 died while 32 cases were treated by operation and 3 died. The patient's APACHE-II scale of operation group were obvious higher than non-operation group's,but there was no remarkable difference of the mortality rate. Conclusion Most of the severe acute pancreatitis can be cured by non-operation methods. Properly choice of operation time and methods, individual treatment may increase survival rate for severe acute pancreatitis.