摘要
目的 探讨重症急性胰腺炎手术治疗的时机和指征。方法 回顾性分析 1 991年至 2 0 0 1年收治的重症急性胰腺炎 2 71例。结果 本组 2 71例重症胰腺炎均行手术治疗。术后并发症有胰周脓肿 1 2例 ,胰腺囊肿 1 9例 ,腹腔出血 2例 ,消化道出血 5例 ,切口裂开 7例 ,肠瘘 8例 ,多脏器衰竭 2 6例 ,并发症发生率 2 9%。死亡 31例 ,病死率 1 3.2 8%。平均住院日 38.6天。结论 重症胰腺炎是常见病 ,治疗不及时或手术方式太复杂 ,则合并症多 ,死亡率高。早期手术治疗对于一些重症急性胰腺炎患者仍然是必须的。胰腺坏死广泛者宜在发生严重感染前进行手术治疗 ,手术亦是病程后期胰腺周围感染为主的局部并发症的主要治疗手段。治疗以手术清除坏死病灶 ,畅通引流 ,早期营养支持为主。
Objective To study therapeutic opportunity and indictations of clinical operation on severe acute pancreatitis.Methods A retrospective study was carried out in 271 patients who underwent severe acute pancreatitis from 1991 to 2001.Results All cases were operated in 271 cases severe acute pancreatitis. postoperation complications included abscess all around of pancreas,pancreatic cyst,hemorrhage of abdominal cavity, hemorrage of digestive tract,disruption of wound,intestinal fistulu,MOF and were abserved patients 12,19,2,5,7,8,26,respectively.incidence rate of complications was 29%,31 cases were suffering from death. morbidty and mortality rate was 13.28%. Average days was 38.6 in hospital.Conclusions Severe acute pancreatitis is conmon discase which was increased on complications and death rate,If to treated was not in time and way of operation too complicated.It is still necessary to several patients who have severe acute pancreatitis as soon as early operatied therapy.It is better to be operated on patients who have extensive pancreatic necrosis before to happen heavy infection.Opertation is essential way to located complications such as infection all around pancreas in later period of pancreatitis as well.Operation was mainly way on removed necrosis,unblocked drainage,enhanced nutrition earier period.If patient complicated abscess all around pancreas or pancreatic cyst who must be operated again.
出处
《兰州医学院学报》
2002年第4期38-39,共2页
Journal of Lanzhou Medical College
