重症急性胰腺炎病程与外科治疗  

Some experience about the diseased course and surgical intervention for severe acute pancreatitis

作　　者：胡铭荣[1] 徐德征[1] 王雄[1] 

机构地区：[1]浙江省杭州市第二人民医院普外科,浙江杭州310015

出　　处：《肝胆胰外科杂志》2004年第1期42-43,共2页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :总结外科手术在重症急性胰腺炎 (severeacutepancreatitis,SAP)治疗中的作用。方法 :对 4 7例SAP病程演变中外科手术治疗情况作回顾分析。结果 :病程第一期行手术 10例 ,主要是解除胆道梗阻 ,降低腹内高压 ,引流胆汁及腹腔渗液 ;第二期行手术 5例 ,主要是清除胰腺坏死组织、引流脓液 ;第三期行手术32例 ,主要是胰、肠瘘的确定性手术及防止胰腺炎再发的胆囊切除术。总治愈率为 85 .1% (4 0 / 4 7) ,总病死率为 14 .9% (7/ 4 0 )。死亡原因 :休克 3例 ,ARDS并急性肾功能衰竭 2例 ,腹腔及后腹膜感染合并霉菌感染致MOSF 2例。结论 :外科手术在SAP治疗中仍具重要地位 ,但手术原因和方式因病期不同而有所不同。Objective:To summarize the experience of surgical intervention on patients with severe acute pancreatitis.Methods:Forty seven patients with severe acute pancreatitis by surgical intervention were analysed retrospectively.Results:The main kinds of surgical intervention included cholesystectomy,exploration of common bile duct,debridement of infected pancreatic necrosis and the determinate operation of pancreatic or intestinal fistula. Total cure rate was 85.1%(40/47),total mortality rate was 14.9%(7/47). The causes of death were shock,ARDS or acute renal failure and MOSF resulted from bacterial or/and fungal infection of pancreas or postperitoneum.Conclusion:The surgical intervention is still very important to the patients with severe acute pancreatitis in the course of the disease development,but the causes and styles of surgical procedures are different with the disease stage of severe acute pancreatitis.

关 键 词：重症急性胰腺炎 外科手术 治疗 

分 类 号：R657.51[医药卫生—外科学]