重症急性胰腺炎的治疗方案探讨

目的:确立重症急性胰腺炎(ASP)的治疗方案.方法:对比研究了以早期手术治疗为主的A组(125例)和以早期非手术治疗为主的B组(108例)的并发症发生率和死亡率.结果:B组的并发症(ARDS、肾衰、心衰、胰腺脓肿)发生率和死亡率均明显低于A组(P<0.001).早期手术治疗未能降低发生休克、胰腺广泛坏死感染及多器官功能衰竭的危险.结论:ASP宜首先进行非手术治疗.

Experience in the Management of Acute Severe Pancreatitis

Objective: To choose an appropriate therapeutic regimen for patients with acute severe pancreatitis (ASP). Methods: A retrospective analysis was carried out in 233 patients with ASP admitted from 1973 to 1997. Comparison was made between 125 patients in group A who were treated mainly by early operation and 108 patients in group B who were treated nonoperatively in terms of complications and mortality rate. Results: The incidence of complications (ARDS, renal failure, heart failure, pancreatic abscess) was lower in group B than group A (P< 0.001); also, the mortality was lower in group B (7.4%) as compared to that (24%) of group A (P<0.001). The strategy of early operation could not reduce the risk of shock, wide-spread pancreatic necrosis and multiple organ failure. Conclusions: Nonope-rative combined modality treatment is to be recommended for ASP initially.