143例急性胆源性胰腺炎治疗的临床分析

Clinical Analysis on Therapy of 143 Biliary Acute Pancretitis Cases

目的:探讨急性胆源性胰腺炎(BAP)的临床诊断和手术时机。方法:2005年6月—2008年12月之间收治的143例BAP患者,根据其是否有胆道梗阻及胰腺是否水肿或坏死分为非梗阻水肿型、非梗阻坏死型、梗阻水肿型以及梗阻坏死型4型,对其治疗方法和临床疗效进行总结分析。结果:非梗阻水肿型BAP93例和梗阻水肿型BAP28例均治愈。非梗阻坏死型BAP11例,治愈10例,死亡1例;梗阻坏死型BAP11例,治愈7例,死亡4例。结论:手术时机对胆源性急性胰腺炎患者的预后有重大影响,早期宜行积极的保守治疗,根据其具体分型制定个体化治疗方案是减少并发症、提高治愈率的关键。

Objective：To investigate the diagnosis and operative opportunity of biliary acute panereatitis. Methods： From June 2005 to December 2008, 143 cases of biliary acute pancreatitis admitted to our hospital were studied. According to obstruction or unobstruction of biliary tract and edema or necrosis of acute pancreatisis, these cases were divided into four types edema acute obstructive or unobstructive biliary pancreatitis and necrosis acute obstructive or unobstructive biliary pancreatitis. Analysis the therapy and the clinical effect on these patients. Results： A total of 93 cases of edema acute unobstructive biliary pancreatitis and 28 cases edema acute obstructive biliary pancreatitis were cured. Ten cases of necrosis acute unobstructive biliary pancreatitis were cured, while one patient died. Seven cases of necrosis acute obstructive biliary pancreatitis were cured, while 4 patients died. Conclusions： Operative opportunity is very important for the prognosis of biliary acute pancreatitis. Reasonable conservative treatment can be adopted for the early phase of biliary acute pancreatitis. The key to reduce complication and improve cure rate is to determine the type of the patients with BAP and selected the proper operative opportunity.