不同手术时机对急性重症胰腺炎的综合影响比较

The comparison of the comprehensive effects of different timing of surgery in severe acute pancreatitis

目的:探讨外科不同手术时机对急性重症胰腺炎(SAP)治疗结果的影响。方法:选择进行治疗的急性重症胰腺炎患者64例为研究对象,根据手术时间分为早期手术组(22例)、延期手术组(23例)和非手术组(19例),就三组患者治疗前后血液淀粉酶、尿液淀粉酶、病死率、治愈率、并发症情况进行统计比较。结果:早期手术组、延期手术组和非手术组的并发症发生率分别为22.73%(5/22),65.22%(15/23),42.11%(8/19);病死率分别为13.64%(3/22),17.39%(4/23),21.05%(4/19);治疗后早期手术组淀粉酶平均水平最低,其次为非手术组,延期手术组平均水平最高。多个参数显示早期手术组对患者病情治疗效果优于延期治疗和非手术治疗。结论:治疗急性重症胰腺炎时应注重个体化治疗,选择合适的手术时机和治疗方式有助于提升疗效。

To investigate the effect of different operation timing in severe acute pancreatitis （SAP）. Methods ： Sixty four cases of early surgery group in our hospital for treatment with severe acute pancreatitis were cho- sen as the research object. According to the operation time ,they were divided into the early surgery group of 22 cases, and 23 cases in the delayed operation group, 19 cases were in the non-surgical group. The blood starch enzymes ,urine amylase ,mortality rate ,cure rate ,complications for the three groups of patients before and after treatment were taken for statistical comparison. Results：The incidence of complications of the early surgery group, the delayed operation group and the non-surgical group were 22.74%（5/22）,65.22% （15/23）,42.11%（8/19）. The mortality was 13.64% （3/22）, 17. 39% （4/23）, 21. 05% （4/19）. After treatment, blood, urine amylase levels of early surgery, followed by non surgical group ,and finally was the delayed operation group. Multiple parameters showed the early surgery group with the disease treatment was better than the extension of treatment and non-surgical treatment. Conclusion：In the treatment of severe acute pancreatitis ,we should focus on individual treatment and to select the appropriate operation timing and treatment. It can help improve efficacy.