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遏制轻型急性胰腺炎向重症转化的非手术 治疗策略
引用本文:蒲青凡,任瑞芳,曹高健,蔡宇,金凯.遏制轻型急性胰腺炎向重症转化的非手术 治疗策略[J].中国普通外科杂志,2006,15(11):14-857.
作者姓名:蒲青凡  任瑞芳  曹高健  蔡宇  金凯
作者单位:温州医学院附属第三医院外一科,浙江,瑞安,325200
摘    要:目的 :探讨遏制急性胰腺炎向重症转化的非手术治疗策略。方法 :将4年间收治的286例轻型急性胰腺炎分为对照组和治疗观察组。对照组采取常规非手术治疗措施;观察组加用改善胰腺微循环,防治细胞钙超载和抑制胰酶的治疗方法。结果 :对照组144轻型有20例转化为重症胰腺炎,14例发生全身性并发症;观察组142例轻型有8例转化为重症,2例出现全身性并发症。观察组重症患者血C-反应蛋白和Balthazar CT严重度指数在治疗后各时点较对照组明显降低。结论 :在常规治疗的基础上加用改善胰腺微循环,防治细胞钙超载和抑制胰酶的治疗措施可能有助于阻止轻型急性胰腺炎向重症化发展。

关 键 词:胰腺炎/治疗  胰腺/血液供给  微循环
文章编号:1005-6947(2006)11-0855-03
收稿时间:2006-05-30
修稿时间:2006-10-08

Nonoperative management strategy to prevent the conversion of mild intosevere acute pancreatitis
PU Qing-fan,REN Rui-fang,CAO Gao-jian,CAI Yu,JIN Kai.Nonoperative management strategy to prevent the conversion of mild intosevere acute pancreatitis [J].Chinese Journal of General Surgery,2006,15(11):14-857.
Authors:PU Qing-fan  REN Rui-fang  CAO Gao-jian  CAI Yu  JIN Kai
Affiliation:The First Department of Surgery, the Third Affiliated Hospital, Wenzhou Medical College, Ruian, Zhejiang 325200, China
Abstract:Objective To discuss the nonoperative management strategy to prevent the conversion of acute pancreatitis to the severe form.Methods In recent 4 years,286 patients with mild acute pancreatitis admitted to our hospital were divided into control group and treatment observation group;routine conservative management was performed in control group,and the strategy of improving pancreatic microcirculation and preventing cell Ca~2+ overload and inhibiting pancreatic protease was added to the treatment observation group.Results Among the 144 patients with mild acute pancreatitis in control group,conversion to severe acute pancreatitis occurred in 20 patients,and 14 of the 20 patients with severe acute pancreatitis developed systemic complications.Among the 142 cases in treatment observation group,the conversion of mild to severe acute pancreatitis occurred in 8 patients,and 2 of the 8 patients developed systemic complications.Serum C-reactive protein levels and Balthazar CT severity index were significantly decreased at each time point in treatment observation group compared to control group.Conclusions In addition to routine management,improving pancreatic microcirculation,preventing cell Ca~2+ overload and inhibiting pancreatic protease might serve as a benificial strategy for preventing the progression of mild acute pancreatitis to the severe form.
Keywords:Pancreatitis/blood  Pancreas/blood supply  Microcirculation
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