中西医结合治疗重症急性胰腺炎的临床研究(附1376例报告)  

Clinical Study on the Treatment of Severe Acute Pancreatitis by Integrated Traditional Chinese Medicine and Western Medicine

作　　者：刘续宝[1] 蒋俊明[2] 黄宗文[2] 田伯乐[1] 胡伟明[1] 夏庆[2] 陈光远[2] 李全生[1] 袁朝新[3] 罗传新[4] 严律南[1] 张肇达[1] 

机构地区：[1]四川大学华西医院普外科,成都610041 [2]四川大学华西医院中西医结合科 [3]四川大学华西医院超声诊断科 [4]四川大学华西医院ICu

出　　处：《四川大学学报（医学版）》2004年第2期204-208,共5页Journal of Sichuan University(Medical Sciences)

基　　金：卫生部临床学科重点建设项目 (批准号 970 5 0 2 3 4)资助

摘　　要：目的　探讨中西医结合治疗重症急性胰腺炎的新治疗方案和有效方法。方法　对不同研究阶段治疗重症急性胰腺炎的方案、方法和疗效进行回顾性对比分析 ,将历时 2 4年的临床治疗研究分为三个阶段。第 阶段(1980～ 1990年 ) ,以早期手术治疗为主 ,中西医结合非手术治疗为辅 ;第 阶段 (1991～ 1993年 )在中西医结合非手术治疗的基础上 ,强调并发症的中转手术治疗 ;第 阶段 (1994～ 2 0 0 3年 )以中西医结合非手术治疗为主要的治疗方法 ,手术治疗主要针对病程后期的感染和局部并发症的治疗。结果　随着中西医结合非手术治疗的不断完善 ,重症急性胰腺炎的手术率和病死率均明显下降。三个阶段的手术率分别为 77.5 9%、5 4 .5 4 %和 19.38% ,而病死率则分别为 4 0 .5 2 %、17.17%和 10 .77%。结论　中西医结合非手术治疗是有效的治疗方法 ,手术治疗是继发感染的主要治疗手段 。Objective To sum up clinical experiences and formulate a new treatment program for the effective managment of severe acute pancreatitis(SAP) by integrated TCM and western medicine. Methods The therapeutic regimens and end results of 1376 cases of SAP in three periods were reviewed and analyzed. Period Ⅰ (1980-1990) was characterized by early surgical intervention supplemented with integrated traditional Chinese and western medical therapy, period Ⅱ(1991-1993) by integrated traditional Chinese and western medical therapy supplemented with surgery for early complications, and period Ⅲ(1994-2003) by integrated traditional Chinese and western medical therapy supplemented with surgery for local infectious complications at a late stage in the course of disease. Results With use of integrated traditional Chinese and western medical therapy in the treatment of SAP, the proportion of surgical operation and the case-fatality rate kept declining in the three consecutive periods, the proportions of operation being 77.59%, 54.54% and 19.38%, and the case-fatality rates being 40.52%, 17.17% and 10.77%, respectively. Conclusion Integrated TCM and western medicine is effective for most SAP cases, and surgery is indicated mainly for late complications such as necrotizing infection. Early surgery should be handled with more circumspection and strictness in most of the patients with SAP.

关 键 词：胰腺炎 中西医结合治疗 手术 

分 类 号：R576[医药卫生—消化系统]