胆源性急性胰腺炎的临床分型与手术治疗

Clinical Classification and Surgery for Gallstone Acute Biliogenic Pancreatitis

目的探讨胆源性急性胰腺炎的个体化治疗方案。方法胆源性胰腺炎156例根据有无胆道梗阻以及病情轻重分为轻症非梗阻型、轻症梗阻型、重症非梗阻型、重症梗阻型,对不同类型临床治疗结果进行回顾性地分析和总结。结果轻症非梗阻型与轻症梗阻型早期手术与延期手术在并发症的发生率、平均住院日、死亡率上差异无统计学意义(P>0.05)。而对重症非梗阻型与重症梗阻型来说,早期手术并发症的发生率高、住院时间长,与延期手术比较,两者之间的差异有统计学的意义(P<0.05),但是重症梗阻型早期手术死亡率低(P<0.05)。结论急性轻症胆源性胰腺炎以早期手术治疗,而重症胆源性胰腺炎待病情稳定后再行手术治疗较为安全。

Objective To evalute the clinical classification and surgery in the treatment of gallstone acute pancreatitis（GAP）. Method The clinical data of 156 patients with GAP admitte to our hospital were studied. These cases which had accptied treatment of surgery were divided into four typs according to ampullary obstruction and severity of acute pancreatitis. Results Whither early operation or lately operation, there was no statistical difference in the complication and average hospital day and death rate between the no - obstructive and obstructive mild type GAP（ P 〉 0.05）. There was statistical difference in the complication and average hospital day between the no- obstructive and obstructive severe type GAP（ P 〈 0.05） ,but there were lower death rate in the early operation（ P 〈 0. 05）. Conclusion The operation can be adopted for the early phase of no-obstructive and obstructive mild type GAP,the severe type GAP should be taken the conservative treatment in the early stage, operation should be taken until pancreatic edema is repressed and patient＇s condition is stable.