重症急性胰腺炎手术与非手术疗效比较

目的 探讨重症急性胰腺炎（ＳＡＰ）手术与非手术的疗效，方法 比较 ＳＡＰ非手术治疗 ４５例（Ａ组）和手术治疗 ９３例（Ｂ组）的临床资料与治疗结果。结果 两组发病年龄、临床表现、就诊时间基本相同，并发症平均发生率 Ａ组为４４．４％、Ｂ组为１１２．９％；住院时间Ａ组平均为３５天，Ｂ组为６３天，两组比较Ｐ＜０．０５；平均医疗费用Ｂ组是Ａ组的１．７７倍；治愈率非手术组为８８．９％，切除术纽为３３，３％，清除术组为７７．４％，三组比较Ｐ＜０．０５，结论 非手术治疗组的疗效优于手术治疗组，可作为首选。在非手术治疗中如出现文中７种情况之一者应转手术治疗。

Comparison of effect of operative and nonoperative methods on patients with severe acute pancreatitis

Objective To explore the effect of operative and nonoperative methods on severe acute pane reati- tis( SAP) Methods To compare the clinical data and results befween nonoperative group (4 cases in Group A) and operative group (93 cases in Group B) in patients with SAP. Results Age of occurrence, clinical symtoms and duration of hospitalization between two groups were basically identical. Average occurrence of complicatiens was 44.44% in Group A and 112.90% in Group B. Average duration of hospitalization was 35 days and 63 days in Group A and B, respectively ,and significant differences were observed in the two group (p < 0.05) . Average medi- cal expenses in Group B were as 1. 77 times as mach as that in Group A.Curative rates were 88.9% ,33.3% and 77.4% in nonoperative, excisional and debridement group respectively, and significant differences existed between nonoperative and excisional group, and between excisional and debridement group (p < 0.05) ,while on difference between nonoperative and debridement group was noticed (p < 0.05) . Conclusion The results showed that nono- perative method should be the first alternative. If one of the seven conditions mentioned in method of choice article occurred during the period of nonoperative treatment ,operative method is indicated.