急性重症胰腺炎非手术治疗剖析.docVIP

急性重症胰腺炎非手术治疗剖析 　　中图分类号：R657.5+1文献标识码： A文章编号： 1814-8824(2008)-8-0013-02 　　摘要:目的 探讨急性重症胰腺炎非手术治疗的效果和可能原因。方法 回顾分析2002年-2007年我院收治急性重症胰腺炎46例的并发症、治愈率、死亡率、中转手术情况。结果 治愈39例（85%），死亡7例（其中非手术组3例、手术组4例）（15%），46例合并症体克6例（13%）、呼吸窘迫综合症6例（13%）、急性肾功能衰竭4例（9%）、上消化道出血13例（28%）、胰腺假囊肿5例（11%）、继发性感染（26%）。结论 急性重症胰腺炎应早期采取积极的非手术治疗，可获得满意的临床效果，早期非手术治疗避免手术的应激反应和减少手术后感染。早期积极防治多器官功能衰竭和胰腺坏死组织继发感染、在非手术治疗过程中合理掌握手术指征，及时中转手术可能是治疗有效的原因。 　　关键词 急性重症胰腺炎 非手术治疗 　　 　　An Analysis of Severe Acute Pancreatitis Non-surgical Treatment.Yang Guo-zhi.Chinese medicine hospital in Yaan City,Sichuan Yaan625000. 　　【Abstract】Objective Of severe acute pancreatitis an effective non-surgical treatment and possible causes.Methods Retrospective analysis of 2002 - 2007 in our hospital treated 46 cases of severe acute pancreatitis complications, the cure rate, mortality rate, interim surgical cases.Results cured 39 cases (85%), killed seven cases (of which three cases of non-surgical group, surgical group four cases) (15%), 46 cases of complications of grams of six cases (13%), six cases of respiratory distress syndrome (13%), acute renal failure in four cases (9%), upper gastrointestinal bleeding in 13 cases (28 percent), five cases of pancreatic false cyst (11%), secondary infection (26 percent).Conclusion Early severe acute pancreatitis should adopt a positive non-surgical treatment, will be satisfied with the clinical results, early non-surgical treatment to avoid surgery to reduce the stress response and post-operative infections. Early positive control multiple organ failure and secondary infection of pancreatic necrosis organizations, non-surgical treatment in the course of a reasonable grasp surgical indications, the timely transfer surgery may be valid reasons for treatment。 　　?【Key words】Severe acute pancreatitis;Non-surgical treatment 　　 　　急性重症胰腺炎发病凶险，病情较重，常伴有多种并发症，死亡率较高。是外科一种危重的急腹症。过去以手术治疗为主，但死亡率仍在30%，随着人民群众的生活水平不断提高以及饮食的改变，急性重症胰腺炎发病率呈上升趋势。近来来对急性重症胰腺炎发病机制、病理研究的深入和重症监护治疗的进展，急性胰腺炎的死亡率明显下降。为了提高胰腺的诊治水平。现将我院5年收治的46例