急性胰腺炎的诊治

目的 探讨急性胰腺炎(AP)诊断和治疗方法。方法 回顾性分析1995年6月至2000年6月收治的19例急性胰腺炎临床病例特征、诊治情况及治疗结果。结果 本组重症胰腺炎7例，轻型12例。手术治疗7例，手术和非手术治疗各死亡1例，非手术治疗的12例中1例死亡亦为重症病人，重症病人组中死亡率为28．6％。入院48h内对重症7例病人行APACFlE．Ⅱ评分，平均8．4分；用CT分级进行分级，I级3例，Ⅱ级2例，Ⅲ、Ⅳ级各1例。主要并发症是急性呼吸窘迫综合征(ARDS)、胰瘘、糖尿病、肠瘘、重症、胰腺脓肿、坏死等。行严密监测下的非手术治疗，在感染出现或已出现并发症时及早行手术。结论对急性胰腺炎病人的治疗要根据临床特征及对疾病的正确评估来决定非手术或手术治疗，在进行非手术治疗的同时，要严密观察病情变化及对治疗的反应情况，一旦发现有手术指征，要及早手术。

Diagnostic and therapy of acute pancreatitis

Objective To explore the methords of early diagnose and operative therapy for acute pancreatitis.Methods The clinical features and the results of diagnosis and treatment in 19 cases of acute pancreatitis from June 1995 to June 2000 were analyzed retrospectively.Results Among the present cases,severe and mild acute pancreatitis were 7 and 12 cases respectively.Seven cases underwent operation and other 13 cases were treated conservatively and 1 case died respectively.Mortality in acute severe pancreatitis group was 28.6%.Conclusion The conservative or operative therapy were determented by patients' clinical features and right evaluation of clinical data.While the supportive conservative therapy being on,we should observe patients' general condition and response of treatment.Once indication of operation is enough,the operation should be performed as early as possible.