急性胆源性胰腺炎个体化治疗方案的探讨  

On the individual treatment protocols of BAP

作　　者：刘菊炎 朱书振 沈宵 游猛 

机构地区：[1]临澧县人民医院普外科,湖南临澧415200 [2]长沙市第三医院普外科

出　　处：《中外医学研究》2010年第14期49-51,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的 探讨急性胆源性胰腺炎个体化治疗方案的临床应用.方法 选择1998年3月～2009年6月所收治的急性胆源性胰腺炎（BAP）230例患者为研究对象,根据BAP轻重程度和有无胆道梗阻分为4类：轻症非梗阻型、轻症梗阻型、重症非梗阻型、重症梗阻型,对不同类型的临床治疗结果回顾性分析和总结.结果 轻症非梗阻型46例,择期手术治疗36例,中转手术6例,非手术治疗4例,均治愈.轻症梗阻型134例,择期手术治疗100例,中转手术28例,非手术治疗6例,均治愈.重症非梗阻型22例,择期手术13例,中转手术9例,死亡3例.重症梗阻型28例,择期手术12,例,中转手术10例,非手术治疗6例,死亡11例.结论 BAP应依据病例类型和动态变化决定其＂个体化治疗方案＂,早期（2周内）保守性治疗多数可收到良好效果,必要时可中转手术治疗,尽可能择期手术处理,仅极少数病例未经手术而治愈.Objective On the clinical application fo individual treatment protocols of biliary acute pancreatitis. Methods During the period from March 1998 to June 2009, a total of 230 consecutive patients diagnosed as Biliary Acute Pancreatitis（BAP） in our institute were di- vided into four classes according to the severity degree and biliary tract obstruction. They were mild -unobstructed BAP, mild -obstructed BAP, severe - unobstructed BAP,and severe - obstructed BAP, after that a retrospecttive analysis and a summary are done according to the clinical treatment outcomes. Results There were 46 cases in mild - unobstructed group who were all completely cured, 36 selective operations, and 6 patients who turned into operations ,4 patients who didn＇t need opreative treatment. 134 cases were in mild - obstructed group who were all completely cured, 100 selective operations ,28 who were conversed to operation, and 6 cases were free from operation. 22 cases were in severe - unobstructed group, 13 selective operations, 9 cases who were conversed to operation, of whom there were 3 hospital deaths. 28 cases were in severe -obstructed group, 12 selective opreations, 10 cases conversed to opreation and 6 cases were free from operation, 11 hospital deaths. Conclusion Individual treatment protocols of biliary acute pancreatitis should be determined according to the types and dynamic changes of the disease, Conservative treatments in two weeks will achieve good effect, and it can be shifted to operation when necessary, and choosing selective operation as soon as possible, Only quite a few patients were healed from non - operative treatment.

关 键 词：急性胆源性胰腺炎 个体化治疗方案 轻症/重症 非梗阻型/梗阻型 

分 类 号：R657.51[医药卫生—外科学]