重症急性胰腺炎的中西医结合治疗研究  

The study on the treatment of severe acute pancreatitis by integrated traditional Chinese medicine and western medicine.

作　　者：刘续宝[1] 张肇达[1] 严律南[1] 蒋俊明[2] 黄宗文[2] 夏庆[2] 胡伟明[1] 田伯乐[1] 陈光远[2] 李全生[1] 袁朝新[3] 罗传新[4] 

机构地区：[1]四川大学华西医院普外科,成都610041 [2]四川大学华西医院中西医结合科,成都610041 [3]四川大学华西医院超声诊断科,成都610041 [4]四川大学华西医院ICU,成都610041

出　　处：《中国实用外科杂志》2005年第3期164-166,共3页Chinese Journal of Practical Surgery

基　　金：卫生部重点项目资助(1997~2000)

摘　　要：目的探讨重症急性胰腺炎中西医结合治疗的新方案和有效方法. 方法对四川大学华西医院1980～2003年连续24年两个不同时期的1376例重症急性胰腺炎(SAP)的治疗原则、方法和结果做回顾性对比分析.1993年以前SAP的治疗以早期手术为主,中西医结合非手术治疗为辅,共215例.1994年开始以中西医结合非手术治疗为主,手术治疗主要针对病程后期的感染和局部并发症,共1161例.结果随着中西医结合非手术治疗方法的完善和作为治疗的主要方法,手术治疗病人的比例减少,病死率明显下降.两个时期的手术率分别为66.98%和19.38%,病死率为29.76%和10.77%.结论中西医结合非手术治疗是有效的治疗方法,手术是治疗感染和局部并发症的主要手段,早期手术指征应从严掌握.Objective To evaluate a new treatment program for the manag em ent of severe acute pancreatitis (SAP) effectively by integrated traditional Chi nese medicine and western medicine.Methods The therapeutic regimens and end results of 1376 cases of SAP in two periods from 1980 to 2003 were reviewed and analyzed.Two hundred a nd fifteen cases in the first phase of 1980~1993 were treated with surgical inte rvention supplemented by integrated traditional Chinese and western medical ther apy,1161 cases in the second phase of 1994~2003 with integrated tradition al Chinese and western medical therapy supplemented by surgery,which was applied to infectious and some other local complications at a late stage in the course of disease. Results With common use of integrated traditional Chinese and western medicine in the treatment of SAP,the proportion of operation and case-f atality rates kept declining in the two consecutive periods,the proportion of op eration in two periods being 66.98% and 19.38%,and the case-fatality rate bei ng 29.76% and 10.77%, respectively.Conclusion Integrated traditional Chinese and western medicine is effective for most SAP patients;surgery is applied mainly to late complicatio ns such as necrotizing infection.Early surgery should be restricted in most of p atients with SAP.

关 键 词：中西医结合非手术治疗 重症急性胰腺炎 并发症 中西医结合治疗 早期手术 病死率 局部 和局 结论 有效方法 

分 类 号：R576[医药卫生—消化系统] R657.51[医药卫生—内科学]