胆源性急性胰腺炎早期非手术治疗探讨

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:2002年3月~2007年3月收治的急性胰腺炎(AP)142例,其中胆源性急性胰腺炎114例,根据有无胆道梗阻及急性胰腺炎轻重程度分为4类:轻症非梗阻型、轻症梗阻型、重症非梗阻型、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40例,在发病3周内经非手术治疗均痊愈;轻症梗阻型35例,在发病3周内经非手术治疗均痊愈。重症非梗阻型20例,行非手术治疗17例,死亡2例,中转手术3例,死亡1例;重症梗阻型19例,非手术治疗15例,死亡2例;中转手术治疗4例,死亡1例。结论:急性胰腺炎(AP)早期(3周内),一般均可非手术治疗,待胰腺炎症水肿消退,病情稳定后及时手术治疗。

Explore in Nonsurgical Treatment of Acute Biliogenic Pancreatitis

Objective:To study the feasibility of nonsurgical treatment of acute biliogenic pancreatitis in the early stage.Methods: From March 2002 to March 2007,142 cases of acute pancreatitis(AP) were studied.Among them,114 cases were diagnosed as biliogenic acute pancreatitis,and divided into four types:acute mild unobstructive biliogenic pancreatitis,mild onstructive one,severe unobstructive one and severe obstructive one.Results: Of them,40 cases of acute mild unobstructive biliogenic pancreatitis were cures by nonsurgical treatment within the first three weeks of disease;35 cases of acute mild onstructive biliogenic pancreatitis were cured,20 cases of acute severe unobstructive biliogenic pancreatitis,17 adopted conservervative treatment and 2 died,including 3 cases receiving emergent operation and 1 died.;of 19 cases of acute severe obstructive biliogenic pancreatitis,15 cases accepted nonsurgical treatment and 2 died,4 were performed with operation and 1 died.Conclusion: Conservative treatment can be adopted for the early phase of BAP(within 3 weeks),operation should be taken until pancreatic edema is repressed and patient's condition is stable.