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目的探讨急性胰腺炎的合理治疗方案。方法回顾性分析2008年1月—2014年1月收治的36例急性胰腺炎患者的临床资料。结果 36例患者中27例经非手术治疗治愈,其中10例急性胆囊炎并结石,2例急性胆囊炎并结石并胆总管结石所引起的胆源性胰腺炎在胰腺炎症状、体征控制后3个月择期行胆囊切除术或胆囊切除+胆总管切开取石+T管引流术;3例因腹腔渗出液较多经非手术+超生引导下腹腔穿刺置管引流治愈;1例因高龄患者,基础病较多且合并MODS死亡;5例合并坏死感染急诊手术治疗后均治愈。结论轻症胰腺炎非手术效果较好;对于胆源性胰腺炎,若无胆道梗阻,应行非手术治疗,待病情缓解后3个月作择期胆道手术,若合并胆道梗阻,应急诊手术,解除梗阻,畅通引流;对于出血坏死性胰腺炎,若腹腔渗出液较多,可行超生引导下腹腔穿刺置管引流,如果合并坏死感染,则应急诊手术。
Objective To investigate the reasonable treatment of acute pancreatitis. Methods The clinical data of 36 patients with acute pancreatitis admitted from January 2008 to January 2014 were retrospectively analyzed. Results Of the 36 patients, 27 cases were cured by non-surgical treatment. Among them, 10 cases of acute cholecystitis complicated with stone, 2 cases of acute cholecystitis with gallstone and common bile duct stones were associated with pancreatitis symptoms and signs 3 Months elective cholecystectomy or cholecystectomy + choledocholithotomy + T tube drainage; 3 cases of more peritoneal exudate by non-surgical + super-guided abdominal drainage under the guidance of drainage; 1 case of elderly patients , More basic diseases and MODS death; 5 cases of necrotic infection were cured after emergency surgery. Conclusions Non-surgical treatment of mild pancreatitis is better; for biliary pancreatitis, without biliary obstruction, non-surgical treatment should be performed until 3 months after elective remission for biliary surgery, if combined with biliary obstruction, emergency surgery, Relieve obstruction, smooth drainage; for hemorrhagic necrotizing pancreatitis, if the peritoneal exudate more feasible under the guidance of the abdomen peritoneal catheterization drainage, if necrosis infection, emergency surgery.