阻止急性胰腺炎由轻型向重症发展的非手术治疗172例报告

Conservative intensive therapies to prevent the deterioration of mild acute pancreatitis

目的 探讨阻止急性胰腺炎 (acutepancreatitis,AP)由轻型向重症发展的非手术治疗方法。方法 总结分析了 1994～ 1996年和 1996～ 1998年两个阶段共收治的 172例AP患者的治疗效果。第 1阶段采取常规保守治疗 ,第 2阶段采取改善微循环和防止细胞钙超负荷的措施。结果 第 1阶段共收治AP患者 78例 ,轻型AP 76例 ,其中有转化为重症AP 8例 ;重症AP 10例 ,出现全身性并发症 9例 ,局部并发症 7例 ,死亡 3例。第 2阶段共收治AP患者 94例 ,轻型AP 92例 ,其中转化为重症AP 4例 ;重症AP 6例 ,出现全身性并发症 4例 ,局部并发症 3例 ,死亡 1例。结论 改善胰腺缺血和防止细胞钙超负荷的治疗有助于阻止AP由轻型向重症的发展 ,限制胰腺坏死 ,改善AP预后。

Objective[WT5”BZ] To evaluate the effect of special conservative managements in preventing the deterioration of acute pancreatitis (AP).[WT5”HZ] Methods[WT5”BZ] 172 AP patients admitted from 1994 to 1996 and from 1996 to 1998 were retrospectively analyzed. Routine conservative managements were given to 78 AP patients in the first period (1994～1996), and special regime aimed at improving the microcirculation and preventing cell Ca 2+ overload besides routine management were given to 94 AP patients in the second period (1996～1998).[WT5”HZ] Results[WT5”BZ] During the first period, 8 out of 76 patients with mild AP deteriorated into severe AP. 9 out of 10 patients with severe AP developed systemic complications,seven patients developed local complications. The mortality rate was 3/78.During the second period, the conversion of mild AP to severe AP developed in 4 out of 92 patients, 4 out of 6 patients with severe AP presented systemic complications,three patients presented local complications,one patient died.[WT5”HZ] Conclusion[WT5”BZ] Improving pancreatic microcirculation and preventing pancreatic cell Ca 2+ overload are helpful not only to prevent the conversion of mild pancreatitis to severe pancreatitis,but also to prevent progressive pancreatic necrosis, and improve the prognosis of acute pancreatitis. [WT5”HZ]