外科手术在治疗重症急性胰腺炎中的作用

Role of operation in treatment of severe acute pancreatitis

目的观察外科手术治疗重症急性胰腺炎的临床效果。方法回顾性分析我院肝胆外科2008年1月-2012年1月收治的重症急性胰腺炎44例的临床资料,分为手术组(n=34)与非手术组(n=10),比较两组的治疗结果 (治愈、好转或死亡)、总住院时间、住院总花费、胃肠内营养开始时间及术后恢复情况。结果两组患者入选时各指标比较差异均无统计学意义;两组在总治疗结果上差异无统计学意义(P>0.05);平均住院时间手术组32.7 d、非手术组45.6 d,平均胃肠内营养开始时间手术组19.8 d、非手术组27.1 d,平均住院总费用手术组12.8万元、非手术组15.3万元,两两比较差异均有统计学意义(P<0.05)。手术中出血量不多,并发症少或无。结论符合一定手术适应证的重症急性胰腺炎择期行外科手术,可提高生存率。

Objective To observe the clinical outcomes of patients with severe acute pancreatitis（SAP） after operation. Methods Clinical data about 44 SAP patients admitted to our hospital from January 2008 to January 2012 were retrospectively analyzed. The patients were divided into operation group（n=34） and non-operation group（n=10）. Following data were compared, including their clinical outcomes（cured, improved or died）, total hospital stay time, total hospitalization cost, enteral nutrition starting time and post-operational recovery. Results No significant difference was found in the indications at admission and in the clinical outcomes between the two groups（P 〉 0.05）. The hospital stay time and enteral nutrition starting time were significantly shorter while the total hospitalization cost was significantly less in operation group than in non-operation group（32.7 vs 45.6 days, 19.8 vs 27.1 days, 128 000 vs 153 000 RMB（Yuan）, P 〈 0.05）. The amount of bleeding was small during operation and few or no complications occurred after operation. Conclusion Operation at a selective time for SAP patients with operation indications can reduce their hospital stay time, alleviate their suffering, and improve their survival rate.