重症胰腺炎的综合治疗体会

目的：探讨重症急性胰腺炎非手术治疗的效果和手术指征。方法：回顾分析本院收治的48例重症急性胰腺炎非手术治疗方案和手术情况。结果：48例患者中治愈46例（95.8％），死亡2例（4．2％），治疗过程中有12例（25％）出现各种并发症。其中多器官功能损伤2例，胰腺假性囊肿9例，急性肺损伤1例，尚有3例行手术治疗，2例因胆管感染不能控制行急诊手术后痊愈，1例胰腺假性囊肿继发感染行手术治疗后因内出血死亡。结论：重症急性胰腺炎经积极非手术治疗可获得满意疗效，应密切观察病情的变化和有无胰腺坏死组织继发感染的发生，必要时行手术治疗。

Therapeutic development for severe acute pancreatitis

Objective ：To discuss the outcome of conservative treatment for severe acute pancreatitis and indication for surgical intervention. Mothods：A total of 48 patients with severe acute pancreatitis were admitted in our department between Jan. 2002 and Aug. 2004. The conservative treatment and surgical indication were retrospectively studied. Results：Of the 48 patients with severe acute pancreatitis,46 patients （95.8%） were cured and the remaining 2 patients（4.2%） died.Various complications were found in 12 patients（25%） during the course of management, which included multiple organ dysfunction syndrome（2）, pancreatic pseudocyst （9） and acute lung injury（1）. Three patients were transferred to surgical intervention because of uncontrollable billiary infection and pseudocyst infection. Conelusion ：The outcome of conservative treatment for severe acute panereatitis is satisfactory. The changes and infection should be observed closely, sometimes operation is necessary.