急性出血坏死性胰腺炎手术方式的再探讨

The valu of operation in the treatment for acute haemorrhagic necrotizing pancreatitis (AHNP)

本文回顾性分析1991年以来手术治疗急性出血坏死性胰腺炎(AHNP)60例。其中发病7日内手术的39例(早期手术),7日后手术的11例(中转手术)。另外10例为胰腺炎急性期度过后择期行胆道手术。早期手术病人按手术方法不同分为两组。A组20例,为传统胰腺广泛引流术。B组19例,为简化手术组。比较两组病人术后低血容量性休克、ARDS、腹腔脓肿的发生率。B组各项并发症发生率及死亡率均明显低于A组,P值均<0.05。结果说明早期手术时尽量减少手术创伤可以降低术后低血容量性休克、ARDS的发生率,降低早期死亡率;术后短时间内拔除引流管,可以减少坏死组织继发外源性感染的机会,降低后期感染死亡率。

Since 1991, 60 cases with acute haemorrhagic necrotizmg pancreatitis( AHNP) have been treated by operation. In early operation group(39 cases) ,the operation was done within 7 days of the onset the patients were classified into two subgroup according the different operative procedure conventional panereatie drainage group(group A)was in 20 cases,simple surgery group (group B) was in 19 cases. The differences in the incidence of complications and mortality between group A and group B was significant statistically (P<0. 05). So the results showed that the simple operation was benifits to the patients with AHNP.