急性坏死性胰腺炎手术时机的探讨

A Study on the Timing of the Acute Necrotic Pancreatitis Operation

急性坏死性胰腺炎(ANP)是临床上死亡率较高的急症。本文分析回顾了我院自1983年～1989年共收治的9例经手术剖腹探查证实为ANP的患者,其中治愈7例,死亡2例。我们认为对于ANP早期实行清创引流术,可降低病死率,提高治愈率,减少术后并发症。通过对9例ANP病例回顾分析,我们认为对ANP最佳手术时机是:1.合并急性腹膜炎征;2.腹穿抽出血性分泌物;3.血钙>2.0mmol/L;4.经内科保守治疗24～48小时不见好转,有恶化倾向;5.没有合并严重的多脏器的损害。

The acute necrotic pancreatitis is one of those acute clinical diseases that have a high death rate. This paper has made a retrospective analysis of all the nine cases which were diagnosed as ANP through surgical probe in our hospital, a- mong them, seven cured, two dead. The conclusion is: to perform drainage debride- ment on the ANP patients at an early stage will reduce the death rate and complication possibility, and increase cure rate. Through the review of the nine cases of ANP, this paper has come to the follow- ing conslusions about the right moment for the operation: 1.the appearance of a peritonitis complication; 2.the bloody secretion extracted by abdominal puncture; 3.blood calcium>2.0mmol/L; 4.no sign of the turn for the better after 24--48 hrs. of medical treatment; 5.the absence of a complicated multi-viscera damage.