CAJ | 학술논문

目的探讨重症胆源性胰腺炎(SBP)的手术时机与预后的关系.方法将SBP患者按照发病至手术时间＜7 d、7～14 d、＞14 d进行分组,比较各组患者的并发症发生率和病死率.结果 2006年至2009年共收治32例SBP患者,男15例,女17例,平均年龄51岁.发病7 d内手术9例,均为胆管梗阻者;7～14 d内于术12例,均为早期非手术治疗效果不佳或加重者;＞14 d手术者11例.三组患者的并发症发生率分别为44.4%、50.0%和45.5%,无显著差异(P＞0.05);病死率分别为11.1%、16.7%和18.2%,亦无显著差异(P＞0.05).结论 SBP应采用个体化的处理方针,伴有胆道梗阻、化脓性胆管炎或病情发展迅猛而非手术治疗无效者应尽早手术,这是降低SBP病死率,改善预后的关键.
목적 탐토중증담원성이선염(SBP)적수술시궤여예후적관계.방법 장SBP환자안조발병지수술시간＜7 d、7～14 d、＞14 d진행분조,비교각조환자적병발증발생솔화병사솔.결과 2006년지2009년공수치32례SBP환자,남15례,녀17례,평균년령51세.발병7 d내수술9례,균위담관경조자;7～14 d내우술12례,균위조기비수술치료효과불가혹가중자;＞14 d수술자11례.삼조환자적병발증발생솔분별위44.4%、50.0%화45.5%,무현저차이(P＞0.05);병사솔분별위11.1%、16.7%화18.2%,역무현저차이(P＞0.05).결론 SBP응채용개체화적처리방침,반유담도경조、화농성담관염혹병정발전신맹이비수술치료무효자응진조수술,저시강저SBP병사솔,개선예후적관건.
Objective To investigate the timing of surgical operation and prognosis of patients with severe biliary pancreatitis (SBP).Methods The patients were classified into three groups according to the interval between disease onset and operation time ( ＜7 d, 7 ～ 14 d, ＞ 14 d).The incidence of complications and mortality were compared among the 3 groups.Results A total of 32 patients of acute pancreatitis due to biliary tract diseases between 2006 and 2009 were included, and there were 15 males and 17 females with a median age of 51 years old.9 patients received operation within 7 days of disease onset and all of these patients were complicated with biliary obstruction;12 patients received operation between 7 ～ 14 days of disease onset and all of these patients were non-respondent to early non-operative management.11 patients received operation after 14 days.The complication rates in the three groups were 44.4% , 50.0% and 45.5%, respectively, the difference was not statistically significant ( P ＞ 0.05 ).The mortality rates in the three groups were 11.1%,16.7% and 18.2%, respectively, and the difference was not statistically significant ( P ＞ 0.05 ).Conclusions The management of SBP should be individualized.Patients with biliary obstruction, suppurative cholangitis or non-respondent to early non-operative management shall be managed surgically, and this is critical to decrease the mortality rates and improve prognosis.