急性出血坏死性胰腺炎早期非手术治疗的转归（附37例临床分析）

The result of non-operative therapy for acute hemorrhagic necrotic pancreatitis(AHNP)(37 cases report)

就１９９２年１月～１９９４年１２月我科３７例经ＣＴ诊断明确的急性坏死性胰腺炎非手术治疗的转归进行分析。结果显示：并发假性胰腺囊肿形成１５例，黄疸２０例，胰腺周围脓肿形成５例，假性胰腺囊肿并出血１例，呼吸功能衰竭行呼吸机辅助呼吸２例，胰瘘４例。３７例病人中，非手术治疗３０例痊愈，１例死亡；６例中转手术，５例痊愈，１例死亡。中转手术的指征是胰腺或胰周的严重感染。手术方式以低创伤为原则。有６例经非手术治疗痊愈出院的胆源性胰腺炎病人，１～３个月后择期行胆道手术时探查未发现胰腺脓肿及坏死灶，部分病人有小的假性囊肿。本组共死亡２例，死亡率５．４％。因此，急性坏死性胰腺炎早期经过正规的非手术治疗，大部分病人可以痊愈，坏死胰腺组织是可以吸收的，非手术治疗是完全可行的。

From Jan.1992 to Dec.1994 37 cases of acute hemorrhagic necrotic pancreatitis (AHNP) were treated with non-operative therapy. Among these 37 cases, 31 cases were treated with non-operative therapy, 30 cases were cured, 1 case died, the rest 6 cases were obliged be operated finally, of them 5 cases were cured,1 case died. In all patients, the complications included: pseudocysts 15 cases; jaundice 20 cases; pancreatic abscess 5 cases; pseudocysts with bleeding 1 case; respiratory failure 2 cases; pancreatic fistula 4 cases. The indications for operation are: severe infection and obstructive jaundice. Our experience is that:non-operative therapy is better than operative therapy for AHNP patients.