不同时期手术治疗急性坏死胰腺炎疗效比较

Comparison Effects of Operation at Different Time on Acute Hemorrhagic Necrotizing Pancreatitis

目的探讨不同时期采取手术治疗对急性出血坏死性胰腺炎的效果的影响,以为手术治疗时机的选择提供依据。方法选择2003年2月-2008年12月于我院治疗的33例急性出血坏死性胰腺炎患者为研究对象,将其按手术时机分为A、B、C三组,其中A组为发病后<3 d内手术,B组为发病后3～7 d内手术治疗,C组为发病>7 d后手术治疗,对所有患者根据其具体情况选取合适的术式进行手术治疗,同时期对三组患者治疗前后的血清淀粉酶、脂肪酶等进行检测比较。结果经手术治疗后,对三组患者的治疗效果、并发症发生率、死亡率及血清淀粉酶、脂肪酶进行比较分析,发现C组各项与A、B组比较,P均<0.05,差异有统计学意义,C组总体效果要优于A、B组。结论在急性出血坏死性胰腺炎的治疗中,应对患者的各项炎症反应进行控制稳定后再手术,这样效果要好于其他时期。

Objective To study the comparison effects of operation at the different time on acute hemorrhagic necrotizing pancreatitis in order to provide evidence for the operation opportunity. Methods Total 18 cases with acute hemorrhagic necrotizing pancreatitis patients from February 2003 to December 2008 in my hospital were divided into three groups. They were divided into A,B,C group according to operation opportunity. A group received operation within 3 days, B group received operation from 3 to 7 days, C group received operation after 7 days. All the patients received different operation according to their situations. At the same time,the level of serum amylase and lipase were detected and compared. Results After the operation, the effect, complication rate, mortality rate and the level of serum amylase and lipase were compared. The result showed that effect of C group was better than that of A and B group, P 〈 0. 05, the difference has statistical significance. Conclusion The inflammation were controled before the operation of treatment of acute hemorrhagic necrotizing pancreatitis ,and is worth further studying