手术治疗重症急性胰腺炎的预后影响因素分析

目的 探讨影响手术治疗重症急性胰腺炎效果的关键因素.方法 将141例患者根据病因分为胆源性组和非胆源性组,比较两组患者早期和延期手术存活率、患者年龄、Ranson's评分、Binder评分、手术距发病平均天数.结果 胆源性组患者早期手术存活率为64.3％,延期手术存活率为64.7％,两者比较差异无统计学意义(P＞0.05).非胆源性组患者早期手术存活率为77.7％,延期手术存活率为81.1％,两者比较差异无统计学意义(P＞0.05).胆源性组中死亡组与存活组年龄、Ranson's评分、手术距发病时间差异无统计学意义,而术前Binder评分两组比较差异有统计学意义,死亡组术前Binder评分偏高.非胆源性组中死亡组与存活组年龄、Ranson's评分差异无统计学意义,而术前Binder评分、手术距发病时间两组比较差异有统计学意义,死亡组术前Binder评分偏高,手术距发病时间较短.结论 手术早晚不是决定外科治疗重症急性胰腺炎的主要因素,而Binder并发症评分可以作为一项评价重症急性胰腺炎手术治疗预后的良好指标.

Influence factors of the prognosis of severe acute pancreatitis treated by surgery

Objective To explore the key factors that affect the effect of surgical treatment for severe acute pancreatitis.Methods 141 patients were divided into chol-genic pancreatitis group and non chol-genic pancreatitis group,and compared the survival rates,age,Ranson’s score,Binder score and days before surgery of two group.Results In chol-genic pancreatitis group,the survival rate of early operation was 71.4%,the rate of delayed operation was 70.6%,and no statistic difference existed between early operation and delayed operation.In non chol-genic pancreatitis group,the survival rate of early operation was 77.7%,the rate of delayed operation was 81.1%,and no statistic difference existed between early operation and delayed operation.In chol-genic pancreatitis group,age,Ranson’s score,days before surgery were no statistic difference between survive and dead,but there was statistic difference in Binder score.In non chol-genic pancreatitis group,age and Ranson’s score were no statistic difference between survive and dead,but there was statistic difference in Binder score and days before surgery.Conclusion Timing of surgery is not the key factor influence surgical therapeutic result.Binder complication score is a good index for assessing the prognoses of severe acute pancreatitis.