148例急性胰腺炎的诊治体会

Experience of Diagnosis and Treatment in 148 Cases of Acute Pancreatitis

目的探讨急性胰腺炎的诊断与治疗。方法对2004年5月-2008年6月收治的148例急性胰腺炎患者发病的诱因、症状、入院后的血尿淀粉酶?B超以及增强CT等临床资料进行回顾性分析。其中轻型102例,重型46例。结果本文148例患者治愈114例,好转25例,死亡9例,发生并发症23例;非手术治疗126例,手术治疗22例。其中死亡病例的死因都与多脏器功能衰竭以及胰腺感染有关。本文22例手术患者均为重症患者。结论急性胰腺炎的诊断主要依靠临床表现,结合辅助检查进行综合分析。治疗上早期以非手术治疗为主,严密监测病情以及预防并发症;对于有胆道梗阻的重症胆源性胰腺炎以及非手术治疗无效的病例需积极尽早手术处理;总之应根据病例特点,综合各种治疗方法制定合理的个体化治疗方案,从而提高急性胰腺炎的治愈率。

Objective To study the diagnosis and treatment of acute pancreatitis.Methods A retrospective study was carried out in 148 patients who underwent acute pancreatitis from May 2004 to June 2008.Among them,102 cases were mild and 46 cases were severe.Results In 148 patients,114 patients were cured,improved in 25 cases and 9 dead,23 cases of complications,non-surgical treatment in 126 cases,22 cases of surgical treatment.The causes of death were correlated with the multiple organs failure and pancreatic infection.Conclusion The diagnosis of acute pancreatitis relied mainly on clinical manifestations,combining comprehensive analysis of auxiliary examination.Early treatment with nonoperative treatment,closely monitoring the illness and give priority to prevent complications,for biliopancreatic obstruction of severe gallstone pancreatitis and nonoperative treatment invalid cases should be actively treated with operation,anyhow should be based on the characteristics of synthesizing various cases,treatment to formulate rational individualized treatment of acute pancreatitis,so as to improve the curative rate.