重症急性胰腺炎的治疗

The treatment of severe acute pancreatitis

探讨重症急性胰腺炎 (SAP)的治疗方法。方法 回顾性分析 10 7例SAP患者非手术治疗及手术治疗的疗效。结果 10 7例中治愈 98例 ( 91 6% ) ,死亡 9例 ( 8 4 % )。89例采用非手术治疗 (其中 16例因并发症行延期手术治疗 ) ,其中仅 3例 1周内死于早期休克 ,2例 2周后死于继发性感染 ;3 4例行手术治疗者 (包括 16例延期手术者 ) ,4例死于术后并发症。结论 SAP早期手术并非完全必要 ,手术治疗的“个体化”方案及非手术治疗的可能性 。

Objective To expore the proper treatment of severe acute pancreatitis(SAP). Methods The effect of 107 patients with SAP treated by non operation or operation was retrospectively analysed. Results 98(91.6%) out of 107 cases were cured and 9(8.4%) died. Among 89 cases treated by non operation(including 16 cases undergoing delayed operation owing to the complications of SAP), 3 died of early shock within 1 week, and 2 died of subsequent infection after 2 weeks; 34 cases were treated by early operations, 4 died of postoperative complications. Conclusions Early operation for SAP is not entirely necessary. Both individual plan of operation and possibility of non operation management represent the change of concept in the treatment of SAP.