104例重症急性胰腺炎的手术治疗与非手术治疗对比分析

A Comparison of the Operation and Non-operation Treatment on 104 Cases with Severe Acute Pancreatitis

目的:探讨重症急性胰腺炎的有效治疗方法以及施行外科手术治疗的时机与指征。方法:回顾性分析104例重症胰腺炎患者的临床治疗资料,其中63例患者行非手术治疗,41例患者行手术治疗,观察比较患者治愈率、死亡率、并发症发生率、住院时间以及治疗前后血尿淀粉酶的变化。结果:①非手术组与手术组间治愈率、死亡率和平均住院时间无明显差异(P>0.05),但手术组并发症发生率显著高于非手术组(P<0.05)。②早期手术组与延期手术组间治愈率比较无明显差异(P>0.05),但延期手术可有效降低患者死亡率与并发症发生率(P<0.05)。③经过治疗,早期与延期手术组患者血尿淀粉酶水平均明显降低(P<0.01),且早期手术组下降幅度大于延期手术组(P<0.05)。结论:非手术治疗与手术治疗的综合治疗可有效提高SAP的治疗效果,同时手术治疗中应尽量避免早期手术。

Objective：To explore the effective treatment of severe acute pancreatitis（SAP） by non-operative or operation treatment,especially the timing and indication of surgery.Methods：The data of 104 cases with SAP treated by non-operative（63 cases） and operative（41 cases） methods were retrospectively analyzed.And the rate of cure,mortality and complication,the average hospital stay were observed and compared between groups,as well as the levels of serum amylase and urine amylase.Results：①No significant difference was found in the cure rate,mortality rate and average hospital stay between non-operation and operation groups（P0.05）,but the complication rate in operation group was higher（P0.05）.②The mortality rate and complication rate in delayed-phase group was significantly lower than early-phase group（P0.05）,but not the cure rate（P0.05）.③ After treatment the levels of serum amylase and urine amylase decreased in operation group（P0.01）,especially in early-phase operation group（P0.05）.Conclusion：The treatment of SAP by the combination of non-operative and operative management was effective,and it would be better that the operation is undergone in the delayed phase.