不同时期手术治疗重症胰腺炎的效果比较

Different Periods Effect of Surgical Treatment of Severe Pancreatitis

目的观察外科手术治疗时机的选择对重症急性胰腺炎(severc acate pancreatitis,SAP)预后的影响。方法将100例SAP患者分为早期手术组(48例)和延期手术组(52例),比较两组病死率和术后并发症的发生率。结果早期手术组和延期手术组病死率分别为31.25%(15/48)和11.54%(6/52),术后并发症发生率70.83%(34/48)和30.77%(16/52)。延期手术组的病死率及并发症发生率均明显低于早期手术组(P<0.05)。结论严格把握手术指征和时机,选择合适术式,可提高SAP治愈率,降低病死率。根据SAP的自然病程,尽量采用"个体化"为原则的非手术或延期手术结合非手术的治疗方案。

Objective To observe the timing of surgical treatment of severe acute pancreatitis（SAP） on prognosis.Methods Totally 100 patients with SAP were divided into the early surgery group（48 cases） and delayed surgery group（52 cases） and were compared mortality and the incidence of postoperative complications.Results The early operation group and the delayed operation group mortality rate was 31.25%（15/48） and 11.54%（6/52）,postoperative complication rate was 70.83%（34/48） and 30.77%（16/52）.Delayed operation group mortality and complications were significantly lower than the early surgery group（P〈0.05）.Conclusion Strict mastering surgical indications and timing,select the appropriate surgical,can improve the SAP cure rate and decrease mortality.According to SAP＇s natural course,as far as possible ＂individual＂ as the principle with non-operative or delayed operation combined with non-surgical treatment.