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目的探讨外科手术在SAP治疗中的作用。方法回顾性分析外科手术治疗的48例SAP的临床资料,比较早期手术者和延期手术者手术病死率和并发症发生率。结果早期手术者手术病死率为19.35%(6/31),延期手术者手术病死率为0,两者差异有统计学意义(P<0.05);早期手术者并发症发生率为32.26%(10/31),延期手术者并发症发生率为52.94%(9/17),两者差异无统计学意义(P>0.05)。结论 SAP早期手术的死亡,最主要的是来自于急性应激期的多器官功能损伤,而非手术本身的打击。外科手术虽是SAP综合治疗体系中重要的一环,但完善的围手术期综合处理,手术中的正确操作和有效引流、手术后重要脏器系统的维护等是SAP患者康复的关键。
Objective To investigate the role of surgery in SAP treatment. Methods The clinical data of 48 cases of SAP treated by surgery were retrospectively analyzed. Surgical mortality and complications were compared between early surgery and delayed surgery. Results The operative mortality rate of early surgery was 19.35% (6/31), while the postoperative operative mortality was 0 (P <0.05). The incidence of complications in early surgery was 32.26% (10 / 31). The incidence of postoperative complications was 52.94% (9/17), with no significant difference between the two groups (P> 0.05). Conclusions The most important cause of death in the early stage of SAP is multiple organ damage in the acute stress phase, not the operation itself. Although SAP is an important part of SAP comprehensive treatment system, the perfect perioperative comprehensive treatment, correct operation and effective drainage during operation, and the maintenance of important organ system after surgery are the keys to the rehabilitation of SAP patients.