老年重症急性胰腺炎手术治疗探讨

Exploration of Surgical Therapy in the Senile Patients with Severe Acute Pancreatitis

目的:讨论老年重症急性胰腺炎的手术治疗。方法:我院1984年1月～2000年10月共收治60岁以上手术证实的重症急性胰腺炎26例,本文对其手术治疗的方法和时机以及相应的并发症和死亡率进行回顾性分析。结果:本组术后死亡6例,其中4例死于MOF,2例死于ARDS。在发病24小时内手术8例中无1例死亡,24～36小时内手术14例有2例死亡,36小时后手术4例均死亡。结论:老年重症胰腺炎患者多伴有心、肺、肾等重要器官慢性疾病,脏器代偿功能差,较易出现MOF,因此如有手术指征或经短期非手术治疗效果不明显者,应及时手术,并在术中和术后采用合理的治疗措施,有利于减少术后并发症,降低手术死亡率。

Objective: To explore surgical therapy in the senile patients with severe acute pancreatitis. Methods: From January 1984 to October 2000, we have treated 26 patients (whose age were over 60 years old) with severe acute pancreatitis in our hospital . The reviewed analysis was alone for operative method and right opportunity as well as relevant complication and mortality. Results: six of them died in post operation of which 4 cases died of MOF and 2 case died of ARDS. None of 8 cases recewing operation in 24 hours of onset died, 2 of 14 cases recewing operation in 24 - 36 hours died, and 4 cases died after 36 hours. Conclusion: The senile patients with severe acute paereatits were exceedingly easy to occur MOF , because of they often combined with chronic diseases of important organs including heart, lung, and kidney etc. Thus , if the operative indication was seen or the curative effect of non - operation treate-ment in a short time was not significant, the operation should be performed as early as possible and adopted rational measure of treatment during and after operation. It will be beneficial to decreation of the postoperative complication and operative mortality.