分期微创手术方式在重症急性胰腺炎外科治疗中的应用

目的 探讨重症急性胰腺炎（SAP）的手术时机及手术方式。方法 对广东省人民医院2000年1月至2004年12月收治的62例SAP病人进行回顾性分析。结果 在早期手术组中，总手术死亡率57．1％，其中开腹手术组和CT引导下穿刺引流组（穿刺引流组）手术死亡率分别为75％和33．3％，两组差异无显著性（P=0．274）。总并发症发生率为57．1％，其中开腹手术组和穿刺引流组并发症分别为100％和0。在延期手术组中，总手术死亡率18．5％，与早期手术组相比差异有显著性（P=0．039），其中开腹手术组和分期微创手术组手术死亡率分别为71．4％和0，两组相比差异有显著意义（P=0．01）；总并发症发生率为25．9％，与早期手术组相比差异具显著性（P=0．01）；开腹手术组和分期微创手术组并发症发生率分别为100％和0，两组相比差异具显著性（P=0．000）。结论 分期微创手术治疗是重症急性胰腺炎外科治疗中一个较好的手术方式。

Application of suegical treatment for severe acute pancreatitis with staged minimally invasive operation

Objective To investigate the timing and method of surgery for severe acute pancreatitis (SAP).Methods Sixty-two patinas with SAP in our hospital from Jan,2000 to Dec,2004 were analyzed retrospectively.Results The overall mortality and morbidity in the early operation group both was 57.1%,compared with 18.5% and 25.9% of those receiving surgery on the late stage( P =0.039, P =0.000).In the early operation group,the mortality in celiotomy group and CT guided percutaneous drainage group was 75% and 33.3%( P =0.274),respectively;the morbidity was 100% and 0%( P =0.000),respectively.In the late surgery group,the mortality in celiotomy group and staged mini-invasive operation group was 71.4% and 0%( P =0.000),respectively,and the morbidity was 100% and 0( P =0.000),respectively.Conclusion The surgical treatment with mini-invasive operation by stages for SAP was one of the effective way.