急性胆源性胰腺炎诊治体会.docVIP

急性胆源性胰腺炎诊治体会 　　doi：10.3969/j.issn.1007-614x.2014.15.36 　　摘 要 目的：探讨急性胆源性胰腺炎的治疗方式及手术时机。方法：收治急性胆源性胰腺炎患者36例，回顾性总结分析其临床资料及治疗方法。结果：21例梗阻型患者发病3天内手术治疗临床痊愈，平均住院天数11天。15例非梗阻型患者早期采取保守性治疗，待症状缓解，1～2周后再行手术治疗临床痊愈，有1例死亡（2.8%），平均住院天数18天。结论：急性胆源性胰腺炎一般均可保守治疗，治疗前首先要判断有无胆道梗阻病变，如伴有梗阻应该给予及时手术治疗；如无梗阻则先给予非手术治疗，等到病情稳定后再行手术治疗，可以减少手术风险，减少并发症，降低手术死亡率。 　　关键词 急性胆源性胰腺炎 治疗 手术时机 　　Diagnosis and treatment experience of acute biliary pancreatitis 　　Wang Chunhua 　　Department of General Surgery，the Peoples Hospital of Shangcai County，Henan 463800 　　Abstract Objective：To explore the treatment method and operation opportunity of acute biliary pancreatitis.Methods：36 cases with acute biliary pancreatitis were selected.Their clinical data and treatment methods were retrospectively analyzed.Results：In the early onset within 3 days，21 patients with outlet obstructed constipation were treated with operative treatment to clinical recovery.The average hospitalization day was 11 days.15 patients with non outlet obstructed constipation were treated with conservative treatment.Patients were treated with non-operative treatment in early，waiting for the relief of symptoms，and they were treated with operative treatment in 1 to 2 weeks to clinical recovery.1 case（2.8%） was death.The average hospitalization day was 18 days.Conclusion：Acute biliary pancreatitis in general can be treated with conservative treatment.We must first determine whether patients have biliary obstruction.If patients with biliary obstruction，they should be given timely operative treatment.If patients without biliary obstruction ，they should be given non-operative treatment， waiting for the relief of symptoms， and they were treated with operative treatment.It can reduce the operation risk，reduce complications，and reduce the operation mortality. 　　Key words Acute biliary pancreatitis；Treatment；Operation opportunity 　　急性胰腺炎是临床常见急腹症之一，因胆道疾病引起的称为急性胆源性胰腺炎（Acute biliary pancrestitis，ABP），胆石病是ABP的主要病因[1]。手术治疗对于急性胆源性胰腺炎的有效性近年来已达到共识，但手术时机、手术方式的