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目的探讨重症急性胰腺炎的治疗。方法总结分析68例重症急性胰腺炎的临床病例资料。结果51例行非手术治疗,死亡4例(7.8%),并发假性囊肿6例(11.8%)。17例行手术治疗,术后死亡4例(23.5%),并发假性囊肿2例(11.8%),腹腔内出血3例(17.6%),胰瘘4例(23.5%),肠瘘1例(5.9%)。结论重症急性胰腺炎以非手术治疗为主,实行“个体化”治疗方案,不宜早期手术。如果病情加重合并脏器功能障碍、黄染加重、胰周大量积液、高热、疑有胰周或胆道感染者为积极手术的指征。
Objective To investigate the treatment of severe acute pancreatitis. Methods The clinical data of 68 cases of severe acute pancreatitis were analyzed. Results 51 patients underwent non-surgical treatment, with 4 deaths (7.8%) and 6 pseudo- cysts (11.8%). Seventeen patients underwent surgical treatment, including 4 cases (23.5%) with postoperative death, 2 cases with pseudocyst (11.8%), 3 cases with intraperitoneal hemorrhage (17.6%), 4 cases with pancreatic fistula (23.5% 5.9%). Conclusions Severe acute pancreatitis is mainly treated by non-surgical treatment. The implementation of “individualized” treatment is not suitable for early operation. If the disease aggravated organ dysfunction, yellow dye increased peritoneal effusion, high fever, suspected pancreatitis or biliary tract infection were indications for active surgery.