重症急性胰腺炎48例临床分析

A Clinical Analysis of Severe Acute Pancreatitis in 43 Patients

目的探讨48例重症急性胰腺炎病例非手术治疗和手术治疗的指征、措施及其效果。方法回顾性分析48例重症急性胰腺炎病例的临床资料,并分组比较。结果确诊病例48例,手术治疗组22例,4例手术后10 d内死亡,死于多器官功能衰竭。2例于术后1个月死亡,死于胰周感染及营养不良。非手术治疗组26例,死亡2人,均死于多器官功能衰竭。结论重症急性胰腺炎(SAP)早期以非手术治疗为主。但是胆源性伴胆道梗阻当经积极治疗而病情不断加重时,则需采取早期手术治疗。

Objective To investigate the treatment measures, indication and effect including operation and non-operation in patients with severe acute panereatitis （SAP）. Methods Clinical data of 48 cases with acute pancreatitis in our hospital were grouped and reviewed. Results There were 48 SAP cases with final diagnosis, in which operative group containing 22 case, 4 cases died within 10 days because of multiple organ failure （MOF）, 2 cases died after 1 month because of pancreas infection and dystrophy;Non-operative group containing 26 cases, 2 cases died because of MOF. Conclusion The main treatment measures of severity acute pancreatitis should be non-operationin at the early stage. But when actue biliary pancreatitis （ABP） or obstruction of biliary tract occured with the progression emerge pathogenetic condition, inspite of active treatment, emphasiis on early operation should been made.