摘要
目的：探讨急性胆源性胰腺炎的治疗方法和手术时机。方法：回顾性分析急性胆源性胰腺炎160例，其中轻症非梗阻型34例、轻症梗阻型62例、重症非梗阻型34例、重症梗阻型30例，对比不同治疗方法下各型患者的死亡率、功能不全脏器数。结果：在轻症非梗阻型、轻症梗阻型病例中，不同治疗方法间各指标比较无统计学意义（P〉0.05）。重症非梗阻型34例中，早期手术死亡率、功能不全脏器数和非手术患者相比，差异有统计学意义（P〈0.05）；重症梗阻型30例中，早期手术死亡率和非手术患者相比，差异有统计学意义（P〈0.05）。结论：对急性胆源性胰腺炎应分型而治。轻症非梗阻型，非手术治疗效果好；轻症梗阻型，一般采取保守治疗，然后择期手术治疗；重症非梗阻型，先积极保守治疗，再根据胰腺坏死是否感染决定是否手术；重症梗阻型，先行短期（24-72小时）积极的非手术治疗，若胆道梗阻未解除，则急诊手术解除胆道梗阻。
Objective： To discuss the treatment method and operation timing of acute biliary pancreatitis.Methods： A total of 160 cases of acute biliary pancreatitis were reviewed,in which the cases number of the mild non-obstructive type,mild obstructive type,severe non-obstructive type,and the severe obstructive type were 34,62,34,30 respectively.The death rate,organ dysfunction of different treatment scheme were analyzed. Results： In mild non-obstructive and mild obstructive type,the indexes of different treatment methods didn′t have statistical significance（P〉0.05）.In 34 cases of severe non-obstructive type,the death rate,and organ dysfunction between early operation and non-operation groups had significant statistical difference（P〈0.05）.In 30 cases of severe obstructive type,the death rate between early operation and non-operation group had statistical difference（P〈0.05）. Conclusion： The treatment of acute biliary pancreatitis should be according to the type.The non-operation effect was good for mild non-obstructive type,but the mild obstructive type should be followed by operation in optional time.For the severe non-obstructive type,the conservative treatment was firstly taken,and operation may be decided according to the infection.The severe obstructive type was firstly treated in short-time（24~72 hours） non-operation measures.If the biliary obstruction was not relived,then the emergent operation was carried out to remove biliary obstruction.
出处
《江苏大学学报（医学版）》
CAS
2009年第1期71-73,共3页
Journal of Jiangsu University：Medicine Edition
关键词
急性胆源性胰腺炎
临床分型
胆道梗阻
治疗
acute biliary pancreatitis
clinical classification
biliary obstruction
treatment
