217例重症急性胰腺炎的治疗

Treatment of severe acute pancreatitis: a review of 217 cases

目的 探讨重症急性胰腺炎(SAP)的治疗经验。方法 回顾性分析收治的2 1 7例重症急性胰腺炎病例的临床特征、病死率和中转手术等资料,其中早期手术6 6例,先非手术治疗后中转手术2 4例。结果 治愈1 7 4例,治愈率8 0. 2%。手术治疗9 0例,治愈6 5例,手术治愈率7 2. 2% ;非手术治疗1 2 7例,治愈1 0 9例,非手术治愈率8 5. 8%。结论 强调以非手术为主的综合治疗,但对有早期手术指征和中转手术指征患者,当及时行手术治疗。

Objective To investigate the principles of treatment for severe acute pancreatitis(SAP). Methods A retrospective analysis of the data of 217 cases of SAP with regards to clinical features,mortality rate and conversion to surgical operation.In this group,66 cases received early operation and 24 cases were converted to operation after initial conservative treatment.Results The overall cure rate was 80.2%(174/217). Among them,90 cases underwent operative treatment,with a cure rate of 72.2%(65/90),and 127 cases underwent conservative treatment with a cure rate of 85.8%(109/127).Conclusions The initial treatment of SAP should be conservative. Operation should be performed if there is a specific indication for early surgical intervention,or for conversion to operation.