摘要
目的 探讨重症胆源性胰腺炎（SBP）的手术时机与预后的关系.方法 将SBP患者按照发病至手术时间＜7 d、7～14 d、＞14 d进行分组,比较各组患者的并发症发生率和病死率.结果 2006年至2009年共收治32例SBP患者,男15例,女17例,平均年龄51岁.发病7 d内手术9例,均为胆管梗阻者;7～14 d内于术12例,均为早期非手术治疗效果不佳或加重者;＞14 d手术者11例.三组患者的并发症发生率分别为44.4%、50.0%和45.5%,无显著差异（P＞0.05）;病死率分别为11.1%、16.7%和18.2%,亦无显著差异（P＞0.05）.结论 SBP应采用个体化的处理方针,伴有胆道梗阻、化脓性胆管炎或病情发展迅猛而非手术治疗无效者应尽早手术,这是降低SBP病死率,改善预后的关键.
Objective To investigate the timing of surgical operation and prognosis of patients with severe biliary pancreatitis （SBP）.Methods The patients were classified into three groups according to the interval between disease onset and operation time （ 〈7 d, 7 ～ 14 d, 〉 14 d）.The incidence of complications and mortality were compared among the 3 groups.Results A total of 32 patients of acute pancreatitis due to biliary tract diseases between 2006 and 2009 were included, and there were 15 males and 17 females with a median age of 51 years old.9 patients received operation within 7 days of disease onset and all of these patients were complicated with biliary obstruction;12 patients received operation between 7 ～ 14 days of disease onset and all of these patients were non-respondent to early non-operative management.11 patients received operation after 14 days.The complication rates in the three groups were 44.4% , 50.0% and 45.5%, respectively, the difference was not statistically significant （ P 〉 0.05 ）.The mortality rates in the three groups were 11.1%,16.7% and 18.2%, respectively, and the difference was not statistically significant （ P 〉 0.05 ）.Conclusions The management of SBP should be individualized.Patients with biliary obstruction, suppurative cholangitis or non-respondent to early non-operative management shall be managed surgically, and this is critical to decrease the mortality rates and improve prognosis.
出处
《中华胰腺病杂志》
CAS
2010年第6期389-391,共3页
Chinese Journal of Pancreatology
关键词
重症胆源性胰腺炎
外科手术
预后
手术后并发症
Severe biliary pancreatitis
Surgical procedures,operative
Prognosis
Postoperative complications
