急性重型胰腺炎伴非感染性胰腺坏死手术时机的选择  

Operation Timing Selection of Acute Severe Pancreatitis with Non-infectious Pancreatic Necrosis

作　　者：杨正嘉 YANG Zhengjia(Department of General Surgery, Jinqiu Hospital of Liaoning Province, Shenyang 110016, China)

机构地区：[1]辽宁省金秋医院普外科,沈阳110016

出　　处：《中国实用乡村医生杂志》2017年第4期52-53,共2页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨急性重型胰腺炎（SAP）伴非感染性胰腺坏死的手术时机。方法选择2014-2016年辽宁省金秋医院收治的73例伴有非感染性坏死的SAP手术患者，依据手术时间不同分为观察组40例和对照组33例。对照组在入院1-3d内行开腹手术治疗；观察组入院后先进行腹腔穿刺置管，约1周后进行开腹手术，比较两组患者的治疗结局。结果观察组病死率为12．5％，与对照组的18．2％XH当，差异无统计学意义（χ^2=0．456，P〉0．05）。观察组并发症发生率为2．5％，低于对照组的18．2％，差异有统计学意5Z（χ^2=5．129，P〈0．05）。观察组死亡患者平均生存时间（11．2±2．6）d，长于对照组的（6．4±0．9）d，差异有统计学意义（t=4．13，P〈0．05）。结论病情允许的情况下，SAP伴非感染性胰腺坏死可在人院后先行腹腔引流和冲洗，待病情稳定后再进行开腹手术，以期降低并发症发生率。Objective To disscuss the operation timing selection of acute severe pancreatitis （SAP） with non-infectious pancreatic necrosis. Methods Seventy-three cases of SAP with non-infectious pancreatic necrosis in Jinqiu Hospital of Liaoning Province from 2014 to 2016 were collected and divided into observation group （40 cases） and control group （33 cases） based on operation time. The control group accepted laparotomy in 1-3 d, while the observation group accepted laparotomy one week after the abdominal drainage. The treatment outcomes of two groups were compared. Results The mortality rate of observation group was similar to that of control group （12.5% vs 18.2%, χ^2= 0.456, P 〉 0.05）. The complication rate of observation group was significantly lower than that of control group （2.5% vs 18.2%, χ2 =5.129, P 〈 0.05）. The average survival time of death patient in observation group was significantly longer than that in control group [（11.2±2.6）d vs （6.4±0.9）d, t =4.13, P 〈 0.05]. Conclusion In the case of the disease allowed, the patients of SAP with non-infectious pancreatic necrosis can accept abdominal drainage and washing before the laparotomy with stable condition to reduce the complication rate.

关 键 词：胰腺炎 急性 重型 坏死 非感染性 手术时机 

分 类 号：R57[医药卫生—消化系统]