手术与非手术治疗对重症急性胰腺炎预后影响的探讨

蒲虹¹ 康焰²
1. 四川省人民医院, 2. 四川大学华西医院

 

目的：探讨手术与非手术治疗对重症急性胰腺炎预后的影响。方法：回顾性分析从2007年1月至2008年12月入住四川大学华西医院ICU的重症急性胰腺炎（SAP）病人134例，分析手术与非手术治疗死亡率的差异。结果：手术与非手术治疗对SAP总体预后影响无差异；SAPⅡ级与APACHE Ⅱ＞8分组患者手术组死亡率均低于非手术组死亡率；手术时间对死亡率及并发症发生差异均无统计学意义。结论：把“个体化”治疗与手术治疗结合起来：对于尚无明显手术指征的SAP病例先采用积极的非手术治疗；对有明显全身感染且全身基础情况差、胆源性胰腺炎患者应及时中转手术。

 

 

Objective:To explore the influence of operation and non-operation on the prognosis of patients with severe acute pancreatitis.Method: Retrospectively analyzing differences between operation and non-operation therapy on 134 patients with SAP who were admitted to ICU of West China Hospital from January 2007 to December 2008.Results: Overall mortality was not different between operation and non-operation group. Mortality of operation group with SAP Ⅱand APACHE Ⅱ＞8 were lower than non-operation group. Time to operation has no influence on the mortality and complication. Conclusions: SAP patients who have no indication of operation should be treated by conservative treatments and monitored closely,otherwise should be operated promptly.