重症急性胰腺炎治疗方法的临床探讨

目的探讨重症急性胰腺炎(severe acute pancreatitis，SAP)患者手术时机与指征。方法回顾性分析我院1999年1月～2004年1月79例SAP患者的治疗方法，手术时机选择与并发症发生率、病死率。结果 本组收集患者79例，其中非手术治疗28例，早期手术治疗33例，延期手术治疗18例。非手术组、早期手术组、延期手术组的并发症发生率分别为7．14％(2例)、33．33％(1l例)和11．11％(2例)，各组病死率分别为3．57％(1例)、15．15％(5例)和5．56％(1例)，早期手术组明显高于其他两组。结论 SAP的治疗选择是直接影响预后的重要因素，应根据SAP的病情实施个体化治疗方案。

Clinical analysis on management of severe acute pancreatitis

Objective To discuss timing and indication of surgery for severe acute pancreatitis (SAP).Methods Clinical data of 79 patients with SAP who received treatment in our hospital between January 1999 and January 2004 were reviewed retrospectively with regard to therapeutic method,timing of surgery,indication,morbidity and mortality.Results Of the 79 SAP patients,28 patients received non-surgical treatment,33 patients received early surgical treatment,and the remaining 18 patients received delayed surgical treatment. The morbidity rate and mortality rate in the non-surgery,delayed surgery and early surgery groups were 7.14%(2/28)and 3.57%,33.33%(11/33)and 15.15% (5/33),and 11.11%(2/18)and 5.56% (1/18),respectively. The morbidity rate and mortality rate of the early surgery group were significantly higher than those of the other two groups.Conclusions Selection of the therapeutic method for SAP is an important factor affecting the prognosis of SAP and should be designed according to the condition of individual patients.