重症急性胰腺炎治疗的临床研究

目的 探讨重症急性胰腺炎(Severe acute panceratitis，SAP)的治疗原则与方法。方法 对1990—2000年收治的102例SAP病人的治疗情况进行回顾性分析。结果 SAP伴胆道梗阻22例均手术治疗，治愈(91％)，病死(9％)，胆囊结石无胆道梗阻者38例，手术治疗20例，治愈9例(95％)。病死1例(5％)；非手术18例，治愈率100％。非胆源性SAP42例，手术治疗23例，治愈70％，病死率30％。非手术治疗19例，治愈率84％，死亡率16％。结论 SAP伴胆道梗阻者应急诊手术，伴胆囊结石但无胆道梗阻者宜先非手术治疗；非胆源性SAP的手术指征应从严掌握。

Clinical study of the treatment for severe acute pancreatitis

Objective To explore the therapeutic principle and method for severe acute pancreatitis(SAP). Methods The treatment data from 102 cases with SAP in our department from 1990 to 2000 were analyzed retrospectively. Results Twenty two patients with SAP accompanied by biliary tract obstruction underwent surgical treatment with a healing rate of 91% and a death rate of 9%. In the 38 cases of SAP with biliary stone but without biliary tract obstruction, 20 patients underwent surgical treatment with a healing rate of 95% and a death rate of 5%, but 18 patients received non surgical treatment with the healing rate of 100%. Of the 42 cases of non biliary SAP, 23 patients underwent surgical treatment with a healing rate of 70% and a death rate of 30%, but 19 patients underwent non operative treatment with a healing rate of 84% and a death rate of 16%. Conclusion Patients with SAP accompanied by biliary tract obstruction should receive emergency operation, but those with SAP accompanied by biliary stone but without biliary tract obstruction should receive non operative treatment first. The surgical indications for non biliary SAP should be strictly controlled.