重症急性胰腺炎的治疗

Management of severe acute pancreatitis

目的探讨重症急性胰腺炎的治疗方法。方法回顾性总结重症急性胰腺炎６９例的治疗情况。结果其中保守治疗４０例，手术治疗２９例。保守治疗重症Ⅰ级３７例，死亡１例；重症Ⅱ级３例，死亡１例。手术治疗重症Ⅰ级６例，均治愈；重症Ⅱ级２３例，死亡４例。结论重症急性胰腺炎有胰腺感染和并发症者应行手术治疗；对年龄大于６５岁者，因更易出现多器官功能衰竭，可适当放宽手术指征；其余的患者则行积极的保守治疗。

Objective To study the method of treating severe acute pancreatitis(SAP). Methods The treatment models of 69 patients with SAP were summarized retrospectively. Results Conservative treatment was adopted in 40 patients(37 patients in grade Ⅰ, 3 in grade Ⅱ), among them, 38 recovered, and 2 died; 29 patients underwent surgical treatment including 6 in gradeⅠ, 23 in grade Ⅱ, 4 patients of grade Ⅱ died. Conclusions Operations should be performed on SAP patients with pancreatic infection and complications. Operation also indicates for the patients of age >65 years, and with no improvement after a short period of non operative treatment because these patients are susceptible to develop MSOF. Non operative treatment is suitable for other patients.