外科治疗50例急性坏死性胰腺炎

SURGICAL TREATMENT IN 50 CASES OF ACUTE NECROTIZING PANCREATITIS

作者回顾性分析近20年中收治50例经手术和病理证实为急性坏死性胰腺炎病人的临床资料。死亡12例(24％)。病死率在发病至手术的时间≤5d组和>5d组分别为52.9％和9.1％(P<0.01),在坏死组织清除组和规则性胰切除组分別为17.1％和55.6％(P<0.05),在给营养支持组和不给营养支持组分别为14.3％和46.7％(P<0.05)。资料提示:本病的手术时间最好推迟到发病5d以后,术式以坏死组织清除为宜,尽早给积极的营养支持有益于改善预后。

This is a retrospective analysis of operative data in 50 cases of acute necrotizing pancreatitis, confirmed pathologically, during the recent 20 years. Twelve patients died, giving an overall mortality of 24 per cent. The mortality: rate was 52.9% in the group in which operations were performed within 5 days, and 9.1% in the group in which operations were performed after 5 days (P< 0.01), it was 17.1% in the necrosectomy group, and 56.6% in the group with partial pancreactomy (P<0.05).The mortality rate was 14.3% and 46.7% in the group receiving nutritional support and in those without nutritional support respectively (P<0.05). Our data indicates that operation delayed if possible for more than 5 days appeared more favorable, and necrosectomy be the operation of choice. Early nutritional support can improve the prognosis of this disease.