重症急性胰腺炎Ⅰ、Ⅱ级胰腺坏死特点和早期手术指征的探讨

摘要

Objective To investigate pancreatic necrotic characteristies and early operation indication for grade Ⅰ and Ⅱ of severe acute pancreatitis（SAP）.Method We retrospectively analyze the pancreatic patholgic findings，clinical symproms，therapeutic methods and death causes of SAP from Jan.1980 to May 2000.Results In the early operation，the pancreatic sporadic focal necrosis was found in 59.2％of grade I of SAP，24.2％ among which later changed into the extensive fusional necrosis，the extensive fusional necrosis in 100％ of grade Ⅱ.Conclusion In the early course of SAP of grade Ⅱ，Operation should be considered as a therapeutic method if nonsurgical management is noneffective.%目的：探讨重症急性胰腺炎（SAP）Ⅰ、Ⅱ级的胰腺坏死特点及早期手术指征。方法：回顾分析我院1980年1月至2000年5月SAP182例的手术病理所见、临床表现、治疗方案和死亡原因。结果：SAPⅠ级中59.2％为胰腺局灶型坏死，其中有24.4％进展为广泛坏死，另40.8％为广泛坏死；SAPⅡ级100％为广泛坏死。广泛坏死在强化非手术治疗前提下适时早期手术能提高治愈率。结论：SAPⅡ级早期非手术治疗无效时应适时手术治疗。