非胆道梗阻性重症急性胰腺炎早期临床治疗探讨

Clinical study of treatment of severe acute pancreatitis with non-obstruction of bile duct in the early phase of disease

目的通过比较不同时期非胆道梗阻性重症急性胰腺炎不同治疗方法的临床结果,探讨重症急性胰腺炎早期(二周内)的治疗方案。方法1997年9月至2006年1月桑植县人民医院普外科和中南大学湘雅三院普外科共收治非胆道梗阻性重症急性胰腺炎175例,其中63例早期接受手术治疗,112例早期行非手术综合治疗,对其临床治疗结果进行回顾性分析和总结。结果63例早期手术治疗组中出现严重并发症者21例,并发症发生率33%,死亡16例,死亡率为25%。早期接受非手术治疗112例中出现严重并发症者19例,并发症发生率为17%,死亡14例,死亡率为12%。两组比较有显著性差异(P<0.05)。结论非胆道梗阻性重症急性胰腺炎早期(二周内)接受非手术治疗并发症发生率及死亡率均明显低于早期(一周内)接受手术治疗者,非胆道梗阻性重症急性胰腺炎早期宜行非手术综合治疗。

Objective By comparating the clinical results of severe acute pancreatitis with non-obstruction of bile duct in different phases, the author investigates the treatment fomula in the early phase of disease. Methotis 175 cases of severe acute pancreafitis with non-obstruction of bile duct were hospitalized during September 1997 to January 2006. Among them, 63 cases were accepted operated treatment in the early phase of disease, and another 112 eases were accepted nonoperated treatment. The authors restrospectively analyse the therapeutic results. Results Among the 63 cases, who were performed in the first week of disease, there occourred severe complications in 21 cases. The complication rate were 33%. 16 cases died, the death rate were 25%. And another 112 cases, who were adopted unoperational treatment within fast two weeks of disease, there occourred severe complications in 19 cases. The complication rate were 17%. 14 cases died, the death rate were 12%. There were distinguished difference between the two groups（P〈0.05）. Conclusions Severe acute pancreatitis with non-obstruction of bile duct can adopt the nonoperational treatment in the early phase of disease （within 2 weeks）. The formula can reduce the complications and mortality.