早期临床干预策略在阻断胰腺炎重症化进程中的作用  

Effect of Early Clinical Interference Strategies on Preventing Conversion of Acute Pancreatitis to Severe Form

作　　者：龚锦文 周桂霞[1] 王惠玲[1] 

机构地区：[1]九江市第一人民医院消化科,江西九江332000

出　　处：《中国普外基础与临床杂志》2009年第10期838-840,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的评价在急性胰腺炎早期应用临床干预策略预防轻症胰腺炎转化为重症胰腺炎或阻断重症胰腺炎进一步恶化的临床疗效。方法将我院2001年1月至2008年12月期间收治的急性胰腺炎患者按胰腺炎诊疗方案不同分为两个治疗阶段,第一阶段(2001年1月至2004年12月)胰腺炎患者采用常规治疗措施,第二阶段(2005年1月至2008年12月)胰腺炎患者采用常规治疗措施加个体化的早期临床干预措施的综合治疗,比较两阶段胰腺炎重症化及重症胰腺炎的预后情况。结果第二阶段胰腺炎重症化率(4.48%)较第一阶段(21.18%)明显降低(P<0.05),SAP平均治愈时间明显缩短(P<0.05),局部、全身并发症发生率及死亡率也均明显降低(P<0.05)。行早期临床干预措施的患者中35例出现了一些不良反应及并发症,但均无严重后果。结论早期临床干预应用于胰腺炎的治疗是阻断胰腺炎重症化进程的有效治疗策略。Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis（SAP）.Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008.Patients in the first phase（from January 2001 to December 2004） were treated by the routine management,and the second phase（from January 2005 to December 2008） by the routine management combined with early clinical interference strategies.Then,the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared.Results Compared with the first phase,the rate of aggravation of acute pancreatitis was significantly decreased in the second phase（4.48% vs.21.18%）,the average healing time of SAP,the incidences of systemic and local complications and the mortality of pancreatitis were reduced（P0.05）.When early clinical interference strategies were performed,some adverse reaction and complications occurred in 35 cases,but without severe consequence.Conclusion Early clinical interference strategies may serve as a beneficial strategy on preventing the progression of mild acute pancreatitis to the severe form or halting the aggravation of acute pancreatitis.

关 键 词：急性胰腺炎 早期临床干预策略 重症化 并发症 

分 类 号：R657.51[医药卫生—外科学]