重症急性胰腺炎的外科治疗和手术时机探讨

Approach for the surgical therapy and operation in patients with severe acute pancreatitis

目的探讨重症急性胰腺炎(SAP)的手术时机,以降低死亡率。方法对1985年至2003年收治的35例SAP进行回顾性分析,所有患者均在ICU行监护及支持治疗。结果非手术治疗26例,治愈24例(92.3%),死亡2例,1例死于多系统器官功能衰竭(MSOF),1例死于急性肾功能衰竭(ARF)。手术治疗9例,治愈5例(55.6%),死亡4例,2例死于MSOF,2例死于ARF。结论手术要根据患者的情况,主要是影像检查结果。对胆源性胰腺炎尽早手术治疗。

Objective To s, udy the indications of operation in patients with severe acute pancreatitis（SAP）. Methods Altogether 35 patients with SAP were treated in department of general surgery from 1985 to 2003. A retrospective study was investigated for the effect of non-operation and operation. Results Of 26 non-operation cases,2 died（7.7 % ）. Of 9 operation cases, 4 died（44.4 % ）. Conclusions The surgical procedure should be simple and efficient drainade in order to reduce the mortality, early surgical operation should be applied for SAP for the original biliary obstruction.