重症急性胰腺炎外科治疗52例分析

Analysis of surgical strategies for severe acute pancreatitis in 52 patients

目的:探讨提高重症急性胰腺炎治愈率、降低病死率的外科治疗策略。方法:对52例重症急性胰腺炎患者非手术治疗37例和手术治疗15例的临床资料进行回顾性分析。结果:非手术治疗治愈率89.2%,病死率8.1%;手术治疗治愈率86.7%,病死率13.3%(P>0.05)。重症Ⅰ级手术率24.1%,治愈率93.1%,病死率3.4%;重症Ⅱ级手术率34.8%,治愈率82.6%,病死率17.4%(P>0.05)。总手术率28.8%,总治愈率88.5%,总病死率9.6%。结论:严格把握手术指征和时机,以非手术综合治疗为主,手术治疗为辅的外科治疗策略,可望提高重症急性胰腺炎治愈率,降低病死率。

Objective：To investigate the surgical treatment strategies for raising cure rate and decreasing fatality of severe acute pancreatitis.Methods：The clinical data of non-operative treatment and operative treatment for 52 patients with severe acute pancreatitis were retrospectively analyzed.Results：For the non-operative treatment（n=37）,the cure rate was 89.2% and fatality 8.1%,while for the operative treatment（n=15）,the cure rate was 86.7% and fatality 13.3%（P〉0.05）.In the severe gradeⅠoperation rate was 24.1%,cure rate 93.1% and fatality 3.4%.In the severe gradeⅡoperation rate was 34.8%,the cure rate 82.6% and fatality 17.4%（P〉0.05）.The total operation rate was 28.8%,total cure rate 88.5% and total fatality 9.6%.Conclusions：The indication and timing for operation should be strictly managed.The surgical treatment strategies should be that non-operative comprehensive treatment is dominant and operative treatment is subordinate,which can raise the cure rate and decrease the fatality of severe acute pancreatitis.