重症急性胰腺炎早期简化手术治疗的临床应用.docVIP

重症急性胰腺炎早期简化手术治疗的临床应用 　　[摘要] 目的 探讨重症急性胰腺炎早期简化手术治疗的临床价值。 方法 回顾分析2005年1月～2012年6月收治的重症急性胰腺炎（SAP）病例资料48例。其中施实早期简化引流手术34例，简称A组。非手术治疗14例，简称B组。采用APACHEⅡ评分软件评估A组术前及术后24 h的最高APACHEII得分，B组入院1周内及1周后的最高APACHEII得分。观察A、B两组治愈率、死亡率及后期并发症发生率和住院床日。 结果 A组术前最高APACHEII 评分（16.5±3.8），术后24 h最高APACHEII评分（18.3±2.6），差异无统计学意义（P0.05）。B组入院1周内最高APACHEII评分（14.2±2.6），1周后最高APACHEII评分（16.7±2.1），差异有统计学意义（P0.05）；平均住院床日比较差异有统计学意义（P0.01）。 结论 早期简化手术治疗手术打击力度有限，对于胆源性SAP尤其是SAP-Ⅱ级患者来说不仅是综合治疗的一种手段更是生命攸关的救治措施，并且具有非手术治疗不可取代的价值。 　　[关键词] 急性胰腺炎；手术 　　[中图分类号] R576 [文献标识码] B [文章编号] 2095-0616（2013）14-176-03 　　Clinical application of reduced surgical treatment of early severe acute pancreatitis 　　GAO Yuyong LI Ming LU Wei 　　Department of Surgery， Tianquan County Peoples Hospital， Tianquan 625000， China 　　[Abstract] Objective To investigate of clinical value of reduced surgical treatment of the early severe acute pancreatitis. Methods The clinical data（January 2005 - June 2012）of 48 cases of severe acute pancreatitis（SAP） were analyzed retrospectively. Among them，34 cases of reduced early surgical drainage were referred to as the A group and 14 cases of non-surgical treatment were referred to as the B group. The highest score of Group A in preoperative and postoperative 24 hours were evaluated by APACHEⅡ score APACHEⅡ scoring software. Using the same method of assessment，the highest score of Group B were evaluated within a week and a week later admitted to hospital. The cure rate，the incidence of mortality，late complications and inpatient bed days for AB two groups were observed. Results In group A，the highest preoperative APACHEⅡ score was（16.5±3.8），the highest APACHEⅡ score 24 h after（18.3±2.6），P0.05. In group B，the highest APACHEⅡ score admission within a week was （14.2±2.6），highest APACHEⅡscore a week after （16.7±2.1），P0.05）. There were very significant differences in average length of stay bed between the two groups（P 　　Conclusion Reduced surgical treatment of the early severe acute pancreatitis have less