青海地区急性重症胰腺炎非手术治疗的策略

The Way of Non-operation Treatment in Severe Acute Pancreatitis in Qinghai Area

目的:探讨急性重症胰腺炎非手术治疗的可行性及策略。方法:对我院183例急性重症胰腺炎分别采用非手术治疗和手术治疗的两种方法进行分析,并对病死率和并发症进行总结。结果:183例中治愈149例(81.42%),非手术治疗119例,病死率和并发症发生率分别为13.45%和47.35%;手术治疗64例,病死率和并发症发生率分别是28.13%和71.87%,两组比较差异有显著性(P<0.05)。治疗结果与入院APACHE-Ⅱ评分有明显关系。结论:急性重症胰腺炎通过非手术治疗可获得较满意结果,早期积极有效的非手术治疗是降低死亡率的关键。

Object：To deal with possibility and strategy of the non-operation treatment for severe acute pancreatitis（SAP） in clinic in Qinghai province.Methods：183 cases of SAP that meet the criteria set by The Pancreas Surgery Branch of Chinese Medical Association,2005,in our hospital were randomly assigned to operation group（n=64,to undergo surgery）,or non-operation group（n=119）.The effect of therapy,mortality and incidence of complications was compared between the both groups.Results：Of 183 cases of SAP,the recovery cases were 149（81.42%）.The mortality and incidence of complications was 13.45% and 47.35% for the non-operation group,respectively,and 28.13% and 71.87% for operative group,respectively.There was a significant difference（P〈0.05） between the non-operation and operation group.The therapy associated remarkably with the values of APACHE II for admission.Conclusion： Non-operation treatment of SAP may contribute to gain the satisfactory therapeutic efficacy.The early non-operation treatment is important to decrease of mortality for SAP.