摘要
目的探究重症急性胰腺炎（severe acute pancreatitis,SAP）腹腔感染患者的手术时机。方法回顾性分析我院2009年1月-2014年6月收治的85例SAP腹腔感染患者的临床资料,按照治疗方法不同将上述患者分为研究组（33例）和对照组（52例）,研究组采用延期手术医治,对照组采用及时手术医治。对比两组手术时APACHE-Ⅱ评分、CRP水平、再次手术率、死亡率和术后并发症发生情况。结果研究组与对照组APACHE-Ⅱ评分分别为（4.83±0.76）分和（9.21±0.58）分,t=30.033,P=0.000;CRP水平分别为（83.57±5.23）mg/L比（102.56±5.32）mg/L,t=16.094,P=0.000,均有统计学差异。研究组和对照组再次手术率分别为27.27%vs.88.46%,χ2=33.098,P=0.000;术后病死率分别为3.03%vs.17.31%,χ2=3.964,P=0.047;并发症发生率分别为21.21%vs.48.08%,χ2=6.207,P=0.013,两组比较均有统计学差异。结论 SAP腹腔感染患者行延期手术临床疗效好,具有再次手术机率低、术后并发症少、死亡率低等优点,值得临床参考应用。
Objective To investigate the clinical effect of the treatment of delayed operation for severe acute pancreatitis complicated with abdominal infection. Methods 85 patients with severe acute pancreatitis associated with abdominal infection in our hospital from January 2009 to June 2014 were selected as the research subjects. The research group（ 33 cases） was treated by delayed operation in 3 - 4 weeks,and the control group（ 52 cases） was treated by surgical treatment within one week. The score of acute physiology and chronic health evaluation（ APACHE-Ⅱ）,C-reactive protein（ CRP） level,reoperation rate,fatality and postoperative complications were compared between the groups. Results The APACHE-Ⅱ score of the study group and the control group were（ 4. 83 ± 0. 76） vs.（ 9. 21 ± 0. 58）,t = 30. 033,P = 0. 000; CRP levels were（ 83. 57 ± 5. 23） mg / L vs.（ 102. 56 ±5. 32） mg/L,t =16. 094,P =0. 000; The chance of reoperation was respectively 27. 27% vs. 88. 46%,χ2= 33. 098,P = 0. 000; The postoperative mortality rate was 3. 03% vs. 17. 31%,χ2= 3. 964,P = 0. 047; The incidence rate of complications was 21. 21% vs. 48. 08%,χ2= 6. 207,P = 0. 013. Conclusion It has better efficacy of the delayed surgery for the severe acute pancreatitis associated with abdominal infection,with low rates of reoperation,postoperative complication and mortality,and it is worthy of clinical promotion.
出处
《中国现代手术学杂志》
2015年第4期259-261,共3页
Chinese Journal of Modern Operative Surgery
关键词
胰腺炎
引流术
延期手术
pancreatitis
drainage
delayed operation
