急性胆源性胰腺炎外科治疗时机探讨

摘要

目的 探讨不同外科治疗方案、手术时间对急性胆源性胰腺炎(ABP)患者预后的影响.方法 选 取112 例我科治疗ABP患者的临床资料,其中轻型胰腺炎73 例,重型胰腺炎39 例,分析不同治疗方案和手术时 机对患者的治愈率和并发症的影响.结果 ① 73 例轻症患者中31 例在2 周~2 个月内,38 例在2 个月后手术治 疗,治愈率高,并发症少,其治愈率差异无统计学意义(P>0.05),但均显著优于4 例72 h~2 周内手术治疗的患者 (P>0.05).超过2 个月手术治疗的患者容易再次出现ABP症状.② 39 例重症患者中22 例在72 h~2 周内手术治 疗,4 例在2 周~2个月手术,治愈率均显著优于发病72 h 内手术治疗的13 例患者(P<0.05).结论 急性胆源性胰 腺炎应采用个体化治疗原则,手术方案及治疗时机是影响预后的重要因素.%Objective To investigate the influence of different therapeutic regimen and operation opportunity on the prognosis of acute biliary pancreatitis (ABP). Methods One hundred and twelve patients with ABP were selected in this study, including 73 cases of mild ABP and 39 of severe ABP. The effect of different therapeutic regimen and operation opportunity on the cure rate and incidence of complications was analyzed. Results ① Of the 73 patients with mild ABP, 31 were treated surgically within 2 weeks to 2 months, and 38 were treated surgically after 2 months, with no statistically significant difference in cure rate, resulting in high cure rate and few complications. The cure rate was significantly lower in the 4 patients treated within 72 h to 2 weeks. The patients taken operation after 2 month were susceptible to recurrence. ② Of the 39 patients with severe ABP, 22 were treated surgically within 72 h to 2 weeks, and 4 were treated surgically within 2 weeks to 2 months, resulting in a significantly higher cure rate than the 13 patients treated surgically within 72 h. Conclusion The operation opportunity is one of the most important factors that impact the mortality of ABP. The principle of individual treatment is of great importance.