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目的在改变早期手术为积极、有效、综合的非手术治疗的基础上,进一步探讨重症急性胰腺炎(SAP)的手术时机,以降低死亡率。方法对1990至1997年收治的143例 SAP 进行分析,所有病人均在 ICU 行监护及支持治疗。前期(1990～1994年),对胰腺感染(包括感染性胰腺坏死或液体积聚及胰腺脓肿)均急诊行引流及清创手术;近期(1995～1997年)采取延期手术的方法,将胰腺感染局限或胰腺脓肿作为手术指征。结果胰腺感染局限或脓肿者的手术次数及手术死亡率明显低于有感染性胰腺坏死或液体积聚立即手术者(P<0.05)。结论胰腺感染局限时手术治疗的效果优于胰腺感染未局限时手术,常一次手术成功。
Objective To further explore the timing of surgery in severe acute pancreatitis (SAP) to reduce the mortality rate based on the change of early surgery as a positive, effective and comprehensive non-surgical treatment. Methods 143 cases of SAP admitted from 1990 to 1997 were analyzed. All the patients were monitored and supported by the ICU. Early (1990 ~ 1994), pancreatic infection (including pancreatic necrosis or fluid accumulation and pancreatic abscess) were emergency drainage and debridement surgery; recently (1995 ~ 1997) to take the method of delaying surgery, pancreatic infection will be limited Or pancreatic abscess as an indication of surgery. Results The number of patients with surgical limitations and abscess of pancreatic infection and the operative mortality rate were significantly lower than those with operative infection of pancreatic necrosis or fluid accumulation (P <0.05). Conclusion The limited operative treatment of pancreas infection is superior to the operation of pancreas infection without limitations, and often the operation is successful.