梗阻型胆源性急性胰腺炎外科手术治疗时机的临床研究

Clinical study on surgical treatment opportunityof obstructive biliary acute pancreatitis

目的:探析梗阻型胆源性急性胰腺炎患者的外科手术最佳治疗时机。方法:选取160例梗阻型胆源性急性胰腺炎患者,按照治疗时机的不同分为早期手术组和延期手术组,每组各80例。早期手术组在入院3天内完成手术,延期手术组在入院后1~3周内完成手术。结果:早期手术组患者治疗有效率为97.5%(78/80),明显高于延期手术组的83.8%(67/80)(P<0.05);早期手术组住院时间明显短于延期手术组(P<0.05)、术后24小时引流量明显少于延期手术组(P<0.05);早期手术组死亡率、复发率和并发症发生率均明显低于延期手术组(P<0.05)。结论:尽早给予梗阻型胆源性急性胰腺炎患者手术治疗,可有效减少死亡率和复发率,缩短住院时间,降低并发症发生率。

Objective To investigate the best surgical treatment opportunity of patients with obstructive biliary acute pancreati-tis. Methods： 160 patients with obstructive biliary acute pancreatitis were selected and divided into early surgery group （ n = 80, re-ceived surgery within 3 days after admission） and deferred surgery group （n = 80, received surgery within 1-3 weeks after admission）according to the time of the surgery. Results： The hospitalization time in the early surgery group was significantly shorter than that inthe deferred surgery group （P〈0. 05）. The mortality, recurrence rate and incidence of complications in the early surgery group weresignificantly lower than those in the deferred surgery group （P〈0. 05）. The effective rate of the early surgery group （97. 5%, 78 / 80）was significantly higher than that in the deferred surgery group （83. 8%, 67 / 80, P〈0. 05）. Further, the 24h drainage volume wassignificantly lower than that in the deferred surgery group （P〈0. 05）. Conclusions： The early surgery for the patients with obstructivebiliary acute pancreatitis can reduce the mortality and recurrence rate, shorten the hospitalization time and reduce the incidence of com-plications.