重症急性胰腺炎诊治策略的临床研究

Clinical Study of Diagnosis and Treatment for Patients with Severe Acute Pancreatitis

目的探讨重症急性胰腺炎的临床特点及有效治疗方法,寻求合理的手术时机和术式,以提高重症急性胰腺炎的整体诊治水平。方法回顾性分析保定市第二医院2007年5月—2009年5月期间19例重症急性胰腺炎患者的临床资料,并评价其诊治的临床效果。结果 14例保守治疗,死亡3例,死因为急性呼吸窘迫综合征(ARDS)2例,急性肾功能衰竭(APF)1例;5例手术治疗,死亡2例,分别为多器官功能衰竭综合征(MODS)和感染脓毒血症各1例。总治愈率74%,病死率26%。结论正确地把握重症急性胰腺炎的治疗时机和指征,合理选择治疗方案,适时手术,对于决定重症急性胰腺炎的预后至关重要。

[ Objective] To investigate the clinical characteristics and effective treatment of severe acute pancreatitis, to seek a reasonable operation time and mode, so as to improve the overall diagnosis and treatment of severe acute pancreatitis. [ Methods] A ret- rospective analysis was conducted on clinical data of 19 patients with severe acute pancreatitis treated in Baoding Second Hospital during May 2007 - May 2009. The clinical effect was evaluated. [ Results] The analysis showed 14 cases received conservative treat- ment, 3 death cases, 2 of ARDS, 1 of APF; 5 received surgery, with 2 death cases （1 of MODS and 1 of infection sepsis ）. The total cure rate was 74%, mortality was 26%. [ Conclusion] The correct choices of treatment time and indicators of severe acute pancreatitis, rational selection of therapeutic plan, timely surgery all play important role in the prognosis of patients with severe acute pancreatitis.