重症急性胰腺炎早期手术指征的探讨

Indication of early operation for severe acute pancreatitis

目的 :探讨重症急性胰腺炎患者早期手术指征。方法 :回顾性分析 1996～ 2 0 0 1年收治的 4 6例重症急性胰腺炎患者的临床资料 ;其中 ,非手术治疗 9例 ,早期手术治疗 2 5例 ,延期手术治疗 12例。结果 :非手术组病死率和并发症发生率均为11.1% ,早期手术组病死率和并发症发生率分别为 4 .0 %和 16 .0 % ,延期手术组病死率和并发症发生率分别为 33.3%和4 1.7% ,三组病死率差异有显著性 (P <0 .0 5 ) ,但并发症发生率差异无显著性 (P >0 .0 5 )。结论 :早期手术对某些重症急性胰腺炎患者仍是必需的 ;经短期治疗后 ,腹胀未明显改善或有加剧 。

Objective:To investigate the indication of early operation for severe acute pancreatitis.Methods:Forty six cases of severe acute pancreatitis were analyzed retrospectively.Nine cases were treated conservatively,25 cases were performed early operations and 12 cases underwent delayed operations.Results:The mortality and the occurrence rate of complications in the conservative treatment group were both 11.1%,while they were 4.0 % and 16.0% in the early operation group,and 33.3% and 41.7% in those receiving surgery on late stage respectively.Among the three groups,patients undergoing early operations had a significantly lower mortality than the other two groups( P <0.05),but the difference in the occurrence of complications was not significant( P >0.05).Conclusions:Early operation is necessary for some of patients with severe acute pancreatitis whose abdominal distension is not relieved or even aggravates by short term regular treatment. [