重症急性胰腺炎35例治疗体会

Individual treatment of severe acute pancreatitis: a report of 35 cases

目的 探讨重症急性胰腺炎 (SAP)的治疗方法。方法 回顾性分析 1 996年～ 2 0 0 1年35例SAP患者的治疗经验。结果 35例中治愈 30例 ,死亡 5例。非手术治疗 2 8例 ,其中 2例 1周内死于早期休克 ,1例 2周后死于继发性感染 ;手术治疗 7例 ,2例死于术后并发症。结论 早期非手术方法可以治愈大多数SAP。明确的胆道梗阻或并发急腹症、胰腺组织坏死继发严重感染时应行手术治疗 ,手术方式以简单易行。

Objective To explore a proper treatment for severe acute pancreatitis(SAP). Methods A retrospective study was made on the clinical data of 35 patients with SAP from 1996 to 2001. Results 30 out of 35 cases were cured and 5 died. Among 30 cases treated by non operation(including 2 cases undergoing delay operation owing to the complications of SAP), 2 died of early shock within 1 week, and 1 died of subsequent infection after 2 week; 7 cases were treated by early operations, 2 died of postoperative complications. Conclusion Most cases of SAP can be cured by non operation in the early stage of SAP. However, confirmed obstruction of biliary tract and acute abdomen, secondary infection during the pancreatic necrotizing tissue should be treated operatively. The key of surgical operation is to ensure enough drainage and resolve the obstruction of biliary tract.