95例胆石性胰腺炎(GP)的早期治疗分析

95 Cases of Gallstone Pancreatitis (GP) Treatment of Early

目的探讨早期手术对胆石性胰腺炎的临床治疗效果同时分析不同临床分型的胆石性胰腺炎的具体临床治疗方法的选择。方法选择在我院诊断为胆石性胰腺炎的95例患者进行回顾性调查研究,其中Ⅰ型患者13例,11例患者进行早期手术治疗,2例患者进行传统非手术保守治疗;Ⅱ型患者36例,33例患者进行早期手术治疗,2例为ERCP+EST治疗,1例患者进行内科治疗;Ⅲ型患者21例,17例进行早期手术治疗,3例患者采取区域动脉灌注联合手术,1例患者采取非手术保守治疗;Ⅳ型患者25例,13例患者进行早期手术治疗,2例为ERCP+EST治疗,10例患者采取传统的内科治疗。结果Ⅰ型患者中进行早期治疗的患者均痊愈,采取非手术治疗的2例患者均死亡;Ⅱ型患者均痊愈,无死亡病例,Ⅲ型患者采取早期手术治疗的患者中有5例因多器官的功能衰竭而死亡,4例区域动脉灌注联合手术的患者均治愈,进行保守非手术治疗的1例患者死亡;Ⅳ型患者中早期手术的患者均治愈,采取内科治疗的患者中有1例死亡。结论早期手术治疗的绝对适应症为梗阻型胆石性胰腺炎,而非梗阻轻型的患者也可以采取早期手术治疗,非梗阻重型的患者一般不应采取早期手术;同时早期手术治疗的患者治愈率与非手术治疗之间有明显的差异并有统计学意义。早期手术治疗可以有效的保证患者的生命安全,保证患者的预后,在临床实践中可以广泛应用。

Objective The clinical treatment of clinical treatment effect of early operation on gallstone pancreatitis and analysis of gallstone pancreatitis in different clinical types of choice. Methods 95 patients were for gallstone pancreatitis in our hospital diagnosed retrospective study, including 13 cases of type I patients,11 patients with early operation treatment, 2 patients were non operation treatment; 36 cases of type II patients, 33 patients with early operation treatment, 2 cases were ERCP＋EST the treatment, 1 patients were mated in Department of internal medicine; 21 cases of patients, 17 cases of early operation treatment, 3 patients take regional artery perfusion combined with operation, 1 patients with non operation adopted conservative treatment; 25 cases of type IV patients, 13 patients with early operation treatment, 2 cases of ERCP＋EST treatment, 10 patients take the Department of internal medicine treatment of traditional. Results Type I patients with early treatment were cured, 2 patients with non operation treatment to take the death; type II patients were cured, no death case, take the type III patients with early operation treatment in 5 cases died of mtdtiple organ failure and death, 4 patients with regional intra-arterial infusion combined with operation of the treatment were cured, conservative non operation of 1 patients died; type IV patients with early operation were cured, the patients of Department of internal medicine treatment in 1 cases of death. Conclusion Early operation treatment of the absolute indications for obstructive gallstone panereatitis, rather than the obslruction light patients may also take the early operation treatment, patients with non-obstructive severe general should not take early operation; at the same time in patients with early operation treatment cure rate and between the non operation therapy has the obvious difference with statistical significance. Early can effectively life safety assurance in patients with operation treatment, guarantee the prognosis of the patients, and can be widely applied in clinical practice.