重症急性胰腺炎首次手术指征与时机的研究  

First operation indication and opportunity of severe acute pancreatitis in The Post-Guideline Era

作　　者：许志伟[1,2] 陈胜[1,2] 朱坚[1,2] 费健[1,2] 陆一凡[1] 雷若庆[1,2] 张圣道[1,2] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科,200025 [2]上海消化外科研究所

出　　处：《腹部外科》2013年第3期155-157,共3页Journal of Abdominal Surgery

摘　　要：目的探讨重症急性胰腺炎首次手术的指征与时机及其对预后的影响。方法回顾121例重症急性胰腺炎病例手术资料，分析在不同的手术指征与手术时机下，病死率及再手术率的变化。结果121例患者共接受了202次手术治疗，再次手术比例为42．1％（51／121），总的病死率为15．7％（19／121）。以腹腔间隔室综合征（ACS）及消化道瘘为手术指征的病例预后较差。发病后第4～7天首次手术的并发症及病死率较高。结论提高重症急性胰腺炎手术疗效关键在于把握正确的首次手术指征和恰当的手术时机。Objective To investigate the indication and opportunity of first operation on the severe acute pancreatitis （SAP）. Methods The clinical operation data of 121 cases of SAP were reviewed retrospectively,and re-operation rate and the mortality in different indications and opportunity were analyzed. Results 121 patients were subjected to 202 operations. The re-operation rate was 42. 1 ~//0 （51/121）, and the mortality was 15.7% （19/121）. The patients whose operation indication was ab- dominal compartment syndrome （ACS） or digestive tract leakage had worse prognosis. The patients whose first operation was done on the 4th day to 7th day had a high re-operation rate and the mortali- ty. Conclusion The key to elevate the curative effect of SAP operation is to seize the correct indication and right opportunity.

关 键 词：胰腺炎 急性坏死性 外科手术 预后 手术指征 手术时机 

分 类 号：R657.51[医药卫生—外科学]