重症急性胰腺炎的治疗与预后临床分析

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)的治疗方法与预后的关系。方法回顾性分析收治的164例SAP的临床特征、治疗方法、并发症、病死率等资料。结果非手术治疗54例;手术治疗110例,其中早期手术69例,延期手术41例。早期手术的并发症发生率和病死率分别为81.2%和30.4%,明显高于非手术及延期手术治疗患者。结论SAP治疗方法是影响疗效的重要因素,早期采用非手术为主的综合治疗能有效降低并发症发生率和病死率,但对有早期手术或延期手术指征的患者,应及时手术治疗。

Therapy and prognosis of severe acute pancreatitis

Objective To investigate the relationship between therapeutic methods and effectiveness in patients with severe acute pancreatitis(SAP).Methods The clinical data of 164 cases of SAP,including clinical features,therapeutic methods,complications and mortality rate,were analyzed retrospectively.Results 54 cases received conservative treatment.110 cases underwent surgical treatment,including early operation in 69 cases,delayed operation in 41 cases.The incidence of complications and the mortality in early operation patients was 81.2% and 30.4%,which was significantly different from that in patients undergoing conservative treatment and delayed-operation.Conclusions The therapeutic strategy is an important factor influencing the prognosis of SAP.Conservative treatment of SAP in the early stage can effectively decrease the incidence of complications and the mortality.If there is a specific indication,early or delayed operation should be performed.