外科手术时机及方式对重症急性胰腺炎疗效的影响

Influence of surgical operation timing and stytle to treatment effect of severe acute pancreatitis

目的:探讨重症急性胰腺炎(SAP)的治疗经验。方法:分析上海交通大学附属第六人民医院2003年1月至2006年1月收治的78例SAP患者临床资料,根据治疗方法不同分为三组,其中早期手术组21例,延期手术组12例,非手术组45例。结果:早期手术组、延期手术组、非手术组的并发症发生率分别为28.5%(6/21)、75%(9/12)、46.6%(21/45);病死率分别为14.3%(3/21)、33.3%(4/12)、17.8%(8/45)。三组之间的并发症发生率及病死率相比较均有显著差异性(P<0.05);其中早期手术组并发症发生率、病死率最低,非手术治疗组次之,延期手术组最高。结论:以个体化综合治疗措施为基础,恰当的选择手术时机与方式有助于提高重症急性胰腺炎疗效。

Objective：To investigate the principles of treatment for severe acute pancreatitis （SAP）. Methods：A retrospective analysis of the clinical data of 78 cases of SAP.. Three groups were divided according to different treatment methods, including early operation group 21 cases, dealy operation group 12 cases and non-operation group 45 cases. Results：The complication mobidity rate was 28.5% （6/21）, 75% （9/12）, 46.6% （21/45） respectively in early operation group,dealy operation group and non-operation group; the mortality rate was 14.3% （3/21）, 33.3% （4/12）, 17.8% （8/45） respectively in early operation group,dealy operation group and non-operation group. There were significant differences among the three groups（ P 〈0.05 ）. The complication mobidity and mortality rates were the lowest in early operation group, conversely, and those were the highest in dealy operation group. As for the non-operation group, in the midist of them. Conclusion：The treatment of SAP should depend on the synthesized principle. The proper operation timing and methods will improve the treatment effect.