老年胆源性急性胰腺炎采取不同手术时机治疗对患者预后的影响

Effects of different surgical opportunity on the prognosis of elderly patients with biliary acute pancreatitis

目的探讨不同手术时机治疗老年胆源性急性胰腺炎的临床效果。方法选取2015年3月至2016年6月揭西县人民医院收治的82例老年胆源性急性胰腺炎患者为研究对象,经随机数字表法分为A、B两组,每组41例,所有患者入院后均给予对症支持治疗,A组行早期(入院后48小时内)手术,B组行择期手术。观察两组患者术后情况、并发症发生率及死亡率。结果 A组术后ApacheⅡ评分显著低于B组,术后下床时间及住院时间明显较B组短,差异均有统计学意义(P<0.05);A组并发症发生率为14.63%,同B组(34.15%)比较,明显较低,差异有统计学意义(P<0.05),A组未见死亡病例,B组死亡率为4.88%,两组差异无统计学意义(P>0.05)。结论老年胆源性急性胰腺炎患者在早期接受手术治疗,可降低并发症发生风险,改善预后,提高存活率,值得推广。

Objective To investigate the clinical effect of different surgical opportunity in the treatment of elderly patients with biliary acute pancreatitis. Methods Eighty-two cases of elderly patients with s biliary acute pancreatitis treated in our hospital from March 2015 to June 2016 were selected as the research object and randomly divided into group A and group B with 41 cases in each group. All patients were given symptomatic and supportive treatment. Patients in group A were treated with early surgery （within 48 hours） while patients in group B underwent elective surgery. The incidence of postoperative complications and mortality rate of the two groups were observed. Results Apache II score in group A was significantly lower than that in group B, the postoperative bed time and hospital stay were significantly shorter than those in B group, and the differences were statistically significant （P〈0.05）. The complication rate of group A was 14.63%, which was significantly lower than that 34.15%） in group B and the difference was statistically significant （P^0.05）. There were no deaths in the A group while the death rate was 4.88% in group B, and there was no significant difference between the two groups （P〉0.05）. Conclusion The elderly patients with biliary acute pancreatitis receiving the early surgery can reduce the risk of complications and improve the prognosis and the survival rate, which is worth promoting.