摘要
目的 探讨胆源性急性胰腺炎 (BAP)早期非手术治疗的可行性。方法 1997年 7月至 2 0 0 3年 5月收治急性胰腺炎 (AP) 157例 ,其中BAP 118例 ,根据有无胆道梗阻及AP轻重程度分为 4类 :轻症非梗阻型、轻症梗阻型、重症非梗阻型及重症梗阻型 ,对不同类型临床治疗结果回顾性分析和总结。结果 轻症非梗阻型 3 8例 ,发病后 2周内非手术治疗均治愈 ;轻症梗阻型 2 6例 ,72h内中转急诊手术 2例 ,均治愈 ;重症非梗阻型 2 5例 ,行非手术治疗 2 2例 ,死亡 2例 ,中转手术 3例 ,死亡 1例 ;重症梗阻型 2 9例 ,非手术治疗 19例 (死亡 1例 ) ,3 6h内经内镜括约肌乳头切开术 (EST) 7例 (死亡 1例 ) ,中转手术 3例 (死亡 1例 )。结论 BAP早期 (2周内 ) ,一般均可保守治疗 ,待胰腺炎症水肿消退 。
ObjectiveTo study the possibility of nonsurgical treatment of acute biliogenic pancreatitis in the early stage.MethodsThe data of 157 cases of acute pancreatitis (AP ) hospitalized from J uly 1997 to May 2003 were studied Among them, 118 cases were diagnosed as biliogenic acute pancreatitis. Therapeutic results of biliogenic acute pancreatitis were analyzed. ResultsOf them, 38 cases of acute mild unobstructive bi liogenic pancreatitis were cured by nonsurgical treatment within the first two w eeks of disease;26 cases of acute mild obstructive biliogenic pancreatitis were cured,except for 2 cases receiving emergent operation within 72 hours;of 25 cases with acute severe unobstructive bilio genic pancreatitis, 22 adopted conservative treatment and 2 di e d;the other 3 cases were transferred to operation, and 1 died;of 29 cases with acu te severe obstructive biliogenic pancreatitis, 19 accepted nonsurgical t reatment and 1 died, 7 were performed with endoscopic sphincterotomy(EST) and 1 died, 3 cases received emergent operation and 1 died. ConclusionConservative treatment can be adopted for the early phase of BAP (within 2 week s ),operation should be taken until pancreatic edema is repressed and patient's c ondition is stable.
出处
《中国实用外科杂志》
CSCD
北大核心
2004年第3期158-160,共3页
Chinese Journal of Practical Surgery
