临床医学论文-重症急性胰腺炎手术治疗与非手术治疗利弊的探讨.docVIP

临床医学论文-重症急性胰腺炎手术治疗与非手术治疗利弊的探讨 ??????????????????? 作者：李廷汉 吴祝东 陈维荣 庄潮平 蔡高阳???? 【关键词】? 重症 ??? 摘要：目的：探讨分析重症急性胰腺炎（SAP）手术治疗与非手术治疗的利弊，以便制订更科学的治疗方法，减少并发症发生率及死亡率，提高疗效。方法：通过对本院近18年来147例重症急性胰腺炎患者手术治疗与非手术治疗的治疗效果进行分析。结果：手术治疗65例，其中早期手术39例，并发症发生率及病死率分别为69.2％及48.7％，延期手术26例，并发症发生率及病死率分别为42.3％及34.6％，非手术治疗82例，并发症发生率及病死率分别为40.2％及29.3％。结论：手术治疗及非手术治疗对SAP均有其利弊，不能片面夸大非手术治疗的作用而忽视手术治疗，应遵循“个体化治疗”的原则，对无明显手术指征的病例先行积极的非手术治疗，密切观察，对有手术指征的患者要把握手术时机，适时手术。 ??? 关键词：重症急性胰腺炎；治疗 ??? Research on the advantages and Disadvantages of Operative or Non-operative treatments for Severe acute Pancreatitis ????? Abstract： Objective：To explore the advantages and disadvantages of operative or non-operative treatments for severe acute pancreatitis (SAP).The aim of this study is to work out a more scientific therapy and reduce the incidence of complications and mortality for patients with SAP. Method： The therapeutic effects of 147 patients with SAP who received operative or nonoperative treatments in our hospital were analyzed. Result： The incidence of complications and mortality were 42.3% and 48.7% respectively in early operating treatment group (n=39), while 40.2% and 34.6% respectively in postponed operating treatment group (n=26).The incidence was 40.2% and 29.3% respectively in those receiving non-operative treatments (n=86). Conclusion： Operative or non-operative treatment of SAP patients has its own advantages and disadvantages. Unilaterally magnify the effects of non-operative treatment and neglect operative one is not true. Principle of individualized treatment should be followed. When patients without obvious indications for operation, energetic non-operative treatments and carefully care should be employed. Operation should be carried out in time when indications for operation comes. ??? Key words：Severe acute pancreatitis (SAP)；Therapy ??? 本文通过对我院近18年来147例SAP患者手术治疗与非手术治疗的疗效进行比较，旨在探讨手术治疗与非手术治疗的利弊。从而制订更科学的治疗方案，达到减少并发症、降低死亡率的目的。 ??? 1临床资料 ??? 1.1一般资料：1985年6月至2003年5月我院收治的重症急性胰腺炎（SAP）共147例，男79例，女68例，最低年龄17岁