早期手术治疗胆源性胰腺炎的临床研究

摘要

Objective To investigate the effect of early surgical treatment on liver and renal function and short-term prognosis in patients with acute biliary pancreatitis,to provide reference for clinical treatment.Methods 100 patients with acute biliary pancreatitis admitted to our hospital from January 2010 to December 2015 were collected,according to different treatment methods were dividedinto two groups,the conservative group (n =50) was treated with drugs,the operation group (n =50) was treated with surgical within 24 h after hospitalization.The liver and kidney function,pancreatic CT score,recurrence rate and mortality rate were compared between the two groups.Results After 7 d treatment,the creatinine,urea nitrogen,total bilirubin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),pancreatic amylase in the operation group were significantly lower than those in the conservative group (P ＜0.05);The CT score and CT score of the operation group were significantly better than those of the conservative group (P ＜ 0.05);The abdominal pain relief time,hospitalization time and body temperature,liver function and leukocyte recovery time were significantly lower than those in the conservative group (P ＜ 0.05);During hospitalization,the mortality of patients in operation group was significantly lower than that in conservative group (P ＜ 0.05);After 3 months of follow-up,the recurrence rate of the operation group was significantly lower than that of the conservative group (P ＜ 0.05).Conclusion Early surgical treatment has significantly improved the liver and kidney function of patients with acute biliary pancreatitis,reduce the occurrence of death and recurrence,improve the prognosis of patients,worthy of clinical attention.%目的 探讨早期手术治疗对急性胆源性胰腺炎患者肝肾功能及对近期预后的影响,为临床治疗提供参考依据.方法 收集2010年1月至2015年12月医院收治的100例急性胆源性胰腺炎,根据不同治疗方式分为两组:保守组(n=50)给予药物保守治疗,手术组(n=50)于入院24 h内给予手术治疗.比较两组患者肝肾功能、胰腺CT评分、复发率及死亡率.结果 治疗7d后,手术组肌酐、尿素氮、总胆红素、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、胰淀粉酶均明显低于保守组(P＜0.05);手术组CT分级及CT评分均明显优于保守组(P＜0.05);手术组腹痛缓解时间、住院时间及体温、肝功能、白细胞恢复时间均明显低于保守组(P＜0.05);住院期间,手术组患者死亡率明显低于保守组(P＜0.05);随访3个月,手术组复发率明显低于保守组(P＜0.05).结论 早期手术治疗明显改善了急性胆源性胰腺炎患者的肝肾功能,减少了死亡及复发的发生,改善了患者预后,值得临床重视.