49例重症急性胰腺炎的综合治疗体会

目的探讨重症急性胰腺炎(SAP)的综合治疗方法。方法回顾总结49例SAP患者的治疗经验。结果治愈40例(81.63%),死亡9例(18.37%),非手术组32例,死亡3例(9.38%),手术组17例,死亡6例(35.29%),两组疗效差异有统计学意义(P<0.05)。结论非手术治疗可以治愈大部分SAP患者,重点在于急性期控制性液体复苏、维持血液动力学稳定,以及合理营养支持,抑制胰液分泌,促进胃肠功能恢复,联合应用抗生素。重症胰腺炎的治疗应实行个体化治疗,严格掌握手术适应证,选择手术一定要慎重,手术方式以简单易行有效为主。

Objective To investigate the severe acute pancreatitis （SAP） integrated treatment.Methods Review and sum up the treatment of patients with 49 patients with SAP experience.Results cured 40 cases：（81.63%）,died in 9 cases （18.37%）,non-surgical group of 32 cases,3 patients died （9.38%）,surgical group of 17 patients died in 6 cases （35.29%）,efficacy difference between the two groups statistical significance （P0.05）.Conclusion Non-surgical treatment can cure the majority of SAP patients,Focused on the acute phase Controlled fluid resuscitation,to maintain hemodynamic stability,and reasonable nutritional support,inhibit pancreatic secretion,promote recovery of gastrointestinal function,the joint application of antibiotics.The treatment of severe acute pancreatitis should be implemented individualized treatment,Surgical indication to strictly control,Select operation must be carefully,Simple and effective surgical approach to the main.