摘要
目的分析64例重症急性胰腺炎患者的治疗疗效,探讨重症急性胰腺炎的合理治疗方法。方法收集64例重症急性胰腺炎患者的病例,对病因和临床症状及体征、影像学及实验室检查、治疗及转归等进行回顾性分析。对非手术治疗组30例与手术治疗组34例患者的临床资料进行对比。结果非手术治疗组30例患者和手术治疗组34例患者的APACHEⅡ评分分别为12.09±1.87、12.14±2.08,两组患者的病情严重程度差异无统计学意义(P>0.05);两组患者的并发症发生率分别为66.7%(20/30)和64.7%(22/34),病死率分别为23.3%(7/30)和20.6%(7/34),两组患者治疗结果对比显示:并发症发生率(P>0.05)和病死率(P>0.05)差异无统计学意义。结论胆源性胰腺炎无胆道梗阻和非胆源性重症急性胰腺炎胰腺坏死未感染者以保守治疗为主;胆源性重症急性胰腺炎患者存在结石嵌顿或胆道梗阻者和非胆源性重症急性胰腺炎胰腺坏死感染者及爆发性胰腺炎保守治疗无好转者以手术为主。治疗应遵循个体化治疗。
Objective To investigate the reasonable method of the treatment of the severe acute pancreatitis.Methods From 1997 to 2009,64 cases of severe acute pancreatitis patients were collected.The etiology and clinical symptoms and signs,radiological and laboratory tests,treatment and outcome were analyzed retrospectively.Clinical data of 30 patients who have been cured with the non-operation method and 34 patients who have been cured with operation was compared.Results In study of 34 operative and 30 non-operative treatments,the score of the APACHE Ⅱ was 12.14±2.08 vs 12.09±1.87（P0.05）,the severity of SAP in two groups had no difference,the incidences of complications were 64.7%（22/34） vs 66.7%（20/30）,the mortality rates were 20.6%（7/34） vs 23.3%（7/30）.There were no statistically significant difference in complication rate（P0.05） and mortality（P0.05） among the two groups.Conclusion Acute gallstone pancreatitis without biliary obstruction and severe acute non-gallstone pancreatitis without pancreatic necrosis should be treated on non-operation method;severe acute gallstone pancreatitis with biliary inflammation and impacted stones or biliary obstruction and severe acute non-biliary pancreatic with necrosis of pancreatitis and outbreak of acute pancreatitis should be treated with operation.Treatment should be based on individualized systematic treatment.
出处
《中华全科医学》
2011年第6期860-862,共3页
Chinese Journal of General Practice
关键词
重症急性胰腺炎
手术治疗
非手术治疗
个体化治疗
Severe acute pancreatitis
Operation
Non-operation
Individual systematic treatment
