急性出血坏死性胰腺炎继发感染的手术时机及转归探讨  

The investigation on the time of operation for the secondary infections of the acute hemorrhagic necrotizing pancreatitis and their outcomes

作　　者：修典荣[1] 侯宽永[1] 袁炯[1] 宋世兵[1] 张桐林[1] 颜南生[1] 周孝思[1] 

机构地区：[1]北京医科大学第三医院外科,100083

出　　处：《中国实用外科杂志》1998年第6期349-350,共2页Chinese Journal of Practical Surgery

摘　　要：目的：探讨急性出血坏死性胰腺炎（AHNP）继发感染后的手术治疗时机的选择及其不同治疗方法对转归的影响。方法：对1988年9月至1997年3月122例AHNP中发生感染的35例治疗进行总结。结果：12例在发生感染后未采取任何手术措施而是经营养支持和抗生素应用而痊愈，治疗时间6～60天（平均21天）；11例于感染后7～60天（平均26天）经过一次清创引流后得到控制，术后平均1周体温降至正常；12例死于感染中毒性休克及与感染有关的器官功能衰竭。结论：手术治疗感染性坏死缺乏理论依据，其效果不满意，且很多感染可以经非手术治疗而治愈；胰腺脓肿的治疗则应以手术为主。To investigate the time and concrete methods of operation for the secondary infections of the acute hemorrhagic necrotizing pancreatitis (AHNP) and their outcomes. Method Retrospective review our experiences on thetreatments of 35 cases secondary infections patients in 122 cases AHNP admitted from September, 1988 to March, 1997.Result 12 patients were cured by the nutrition supports and antibiotics instead of operations in their 6th to 60th days(21 days in average); 11 patients recovered after the single drainage operation performed in their 7th to 60th days(26days in average)and their temperatures were normal one week in average after the operations; 12 patients died of the in-fections shock and multiple organs dysfunctions related with it. Conclusion Operative treatment for the infectionsnecrotic mass lack of theoretical basis and the results of operation are not satisfaction. Besides,quite a few of them can becured through nonoperative procedures; The pancreatic abscess should be treated mostly by operation and can be cured bylittle incision.

关 键 词：坏死性 胰腺炎 继发感染 手术时机 转归 AHNP 

分 类 号：R657.51[医药卫生—外科学]