52例重型急性胰腺炎的外科综合治疗分析

目的总结重症急性胰腺炎（SAP）的外科治疗经验,探讨合理的治疗方案.方法对1990年～2005年收治的52例SAP患者的资料进行回顾性分析.结果 20例早期手术患者的死亡率为35%（7/20）,并发症发生率分别为急性呼吸窘迫综合征（ARDS）25%（5/20）、休克35%（7/20）、肾功能衰竭20%（4/20）、心功能不全45%（9/20）;32例早期非手术结合后期手术综合治疗患者的死亡率为15.63%（5/32）,并发症发生率分别为ARDS 6.25%（2/32）、休克12.5%（4/32）、肾功能衰竭12.5%（4/32）、心功能不全15.63%（5/32）.两组患者的死亡率及并发症发生率均有显著性差异（P＜0.05）.结论采取早期非手术结合后期手术综合治疗SAP能有效降低病死率和并发症发生率.

Multidisciplinary Treatment of Severe Acute Pancreatitis in Surgery: a 52 Cases Report

ObjectiveTo summarize experience of surgical treatment of severe acute pancreatitis (SAP) and find out suitable treatment program.MethodsThe data of 52 SAP cases treated from 1990 to 2005 were analyzed retrospectively.ResultsThe mortality rate of 20 cases received operation at early stage was 35% (7/20) and the incidence rates of complications such as adult respiratory distress syndrome (ARDS), shock, renal failure and cardiac failure were 25% (5/20), 35% (7/20), 20% (4/20) and 45% (9/20) respectively. While, the mortality rate of 32 cases received non-surgical treatment at early stage and operation in the later stage was 15.63% (5/32), and incidence rates of ARDS, shock, renal failure and cardiac failure were 6.25% (2/32), 12.5% (4/32), 12.5% (4/32) and 15.63% (5/32) respectively. There was a significant difference between two groups ( P<0.05).ConclusionIntegrated treatment that non-surgical procedures at early stage combined with operation in the later stage can effectively decrease mortality rate and complications.