急性出血坏死性胰腺炎64例治疗体会  

TREATMENT EXPERIENCE OF 64 CASES OF ACUTE HEMORRHAGIC NECROTIC PANCREATITIS

作　　者：顾宪文[1] 冯培勤[2] 叶家全[1] 季辉[1] 

机构地区：[1]临沂市中医医院,临沂276002 [2]临沂医专外科学教研室

出　　处：《临沂医学专科学校学报》1998年第2期105-108,共4页Journal of Linyi Medical College

摘　　要：目的观察8年间治疗急性出血坏死性胰腺炎（AHNP）64例（其中非手术综合治疗9例，先行非手术治疗再行晚期手术24例，早期手术治疗31例）的治疗效果。方法非手术综合治疗为尽早行快速扩容，应用血管活性药物，抑制胰腺分泌，有效的抗生素，营养支持和防治并发症的发生。根据有无感染确定手术时机，手术方式采用胰床灌洗引流、坏死组织清除，规则性胰腺切除和肢，肿切开引流。结果非手术综合治疗9例，死亡率为11．1％，先行非手术综合治疗后再手术24例，死亡率为12．5％，早期手术治疗31例，死亡率为25．8％。结论对AHNP先行综合非手术治疗可明显降低死亡率，晚期手术较早期手术可提高治愈率。积极防治并发症是提高治疗效果的重要一环。Objective To observe the therapeutic effect of 64 cases of acute hemorrhagic necrotic pancreatitis(AHNP) which have been treated in recent 8 years. Amongthem,9 cases were treated with non-surgical combined method, 24 cases with advancednon-surgical combined method first and then with surgical treatment,and 31 cases withsurgical treatment in the early stage. Methods Non-surgical combined treatment isbenefical to the early quick enlarging of volume,the application of vaso-active medicineand antibiotics which effectively inhibit the pancreatic secretion (sandostation is better)and to the supporting of nutrition and the prevention of the occurrence of complications.The time of operation was set according to the patient's condition. During the operation,lavation and drainage of pancreatic bed,removal of necrotic tissues,regular cutting andincision and drainage of abscess were adopted respectively. Results 9 cases were treatedwith non - surgical combined method I the death rate being11. 1%; 24 cases with advanced non-surgical combined method,the death rate being 12. 5%; 31 cases with earlysurgical treatment, the death rate being 25. 8%. Condusion Advanced combined non surgical treatment for AHNP could obviously lower the death rate while later surgicaltreatment might increase the curative ratio. The active prevention of the occurrence ofcomplications is critical in enhancing the therapeutical effect on this disease.

关 键 词：胰腺炎 急性 出血坏死性 外科手术 治疗 

分 类 号：R657.510.5[医药卫生—外科学]