重症急性胰腺炎外科干预的时机、指征与方式选择

The timing,indication and procedure of surgical intervention for severe acute pancreatitis

目的探讨重症急性胰腺炎(SAP)外科干预的时机、指征与方式选择。方法回顾性分析1992年7月至2004年1月收治的216例SAP病例,其中非手术治疗87例(40.3%),外科干预治疗129例(59.7%)。结果总并发症发生率47.2%(102/216),总病死率17.6%(38/216),总治愈率82.4%(178/216)。并发症发生率:非手术组为36.8%(32/87),外科干预组为54.3%(70/129),P>0.05;病死率:非手术组为16.1%(14/87),外科干预组为18.6%(24/129),P>0.05;治愈率:非手术组为83.9%(73/87),外科干预组为81.4%(105/129),P>0.05。结论正确地把握SAP的外科干预时机与指征,合理地选择外科干预方式,对于决定SAP预后至关重要。

Objective To investigate the timing, indication and procedure of surgical intervention for severe acute pancreatitis (SAP).Methods The clinical data of 216 patients with SAP from July 1992 to January 2004 were retrospectively analyzed.Eighty-seven cases (40.3%) received non-operative treatment and 129 cases (59.7%) received surgical intervention.Results In this group,overall incidence of complication,overall mortality and overall curative rate were 47.2%(102/210),17.6%(38/216) and 82.4(178/216),respectively.The incidences of complication in non-operative group and in surgical intervention group were 36.8%(32/87) and 54.3%(70/129),respectively (P>0.05).The mortality in non-operative group and in surgical intervention group were 16.1%(14/87) and 18.6%(24/129),respectively (P>0.05).The curative rates in non-operative group and in surgical intervention group were 83.9%(73/87) and 81.4%(105/129),respectively (P>0.S05).Conclusion Appropriate choice of the timing,indication and procedure of surgical intervention is vital to the prognosis of SAP.