急性胆源性胰腺炎56例临床诊治体会

Experience of diagnosis and treatment of 56 cases of acute gallstone pancreatitis

目的:探讨急性胆源性胰腺炎(acute gallstone pancreatitis,AGP)治疗方法及手术时机。方法:治疗根据病情和类型而定,先行保守治疗,同时密切观察病情变化,出现中重型向重型转变,或出现急性化脓性胆总管炎行手术治疗。56例AGP保守治疗(保守组)34例,手术治疗(手术组)22例。结果:保守组与手术组在住院天数、治疗后出现并发症例数与死亡例数差异均无统计学意义(P>0.05)。保守治疗出现肝功能损害2例,血糖升高2例,胰腺假性囊肿1例;手术组出现切口感染2例,腹腔细菌性感染1例,因多器官功能障碍综合征死亡1例。结论:积极有效的保守治疗与及时的外科手术处理对急性胆源性胰腺炎均有重要意义。

Objective：To explore treatment and optimal surgical time of acute gallstone pancreatitis（AGP）.Methods：The methods of AGP treatments required to according to conditions and types of the disease.The conservative treatment could be done firstly,and the operation opportunity should be individualized.The severe pancreatitis patients with acute obstructive suppurative cholangitis should accept surgery earlier to remove obstruction,remove fluid or purulent material.Among 56 cases with AGP,22 cases accepted surgical treatment and 34 cases accepted conservative treatment.Results：The diffrences of hospital stay,complications and death in two groups were not statistically significant（P0.05）.Two cases after surgical treatment were with liver functional lesion,two cases with rising of blood glucose and one cases with pseudocyst;two cases after consevuative treatment were with wound infection,one with abdominal bacterial infection and one case died from MODS.Conclusions：It is imporfart active and effeitive conser vative treatment and timely surgery of AGP.