重症急性胰腺炎治疗方法的探讨

目的：探讨重症急性胰腺炎（SAP）合理的治疗方案，方法：1999年1月至2000年11月我科经治的SAP患者51例，采用非手术综合治疗48例（其中行EST8例，短时血滤4例）；急诊手术引流治疗3例（SAP并化脓性腹膜炎，胰腺脓肿），结果：治愈率94．12％（48／51），死亡率5．88％（3／51），结论：48例SAP患者采用非手术综合治疗，46例治愈，EST有助于去除胆源性SAP的病因，短时血滤可减轻SAP并发脏器功能障碍的症状，SAP并发化脓性腹膜炎及胰腺脓肿必须进行引流手术。

Explore the appropriate therapeutic scheme of severe acute pancreatitis

Objective To explore the appropriate therapeutic scheme of severe acute pancreatitis (SAP). Methods 51 cases treated from Jan. 1999 to Nov. 2000 were reviewed. All patients admitted in ICU, and their important visceral functions were monitored and treated. 48 cases were treated with non-surgical comprehensive therapy (8 cases by endoscopic sphincterctomy, 4 cases by hemodialysis). 3 cases complicated purulent peritonitis and pancreatic abscess were treated by drainage. Results The total cure rate was 92.12% (48/51) and the mortality rate was 5.88% (3/51). Conclusion 46 cases were cured by non-surgical comprehensive therapy. EST is helpful for treating gallstone SAP. Short-term hemodialysis may ameliorate the symptoms of visceral dysfunctions complicated SAP. When complicated purulent peritonitis and pancreatic abscess, SAP patients should be taken the drainage operation. In order to get rid of the causative factors, the appropriate operative therapy should also be adopted if necessary.