CAJ | 학술논문

目的　探讨重症胰腺炎的手术指征和手术时机。　方法　回顾性分析82例重症胰腺炎的治疗情况，其中行非手术治疗10例、早期手术44例、延期手术28例。　结果　本组总并发症发生率为24％、总病死率为18％。非手术组10例均痊愈，并发症发生率为10%；早期手术组死亡5例，并发症发生率和病死率分别为14%和11%；延期手术组死亡10例，并发症发生率和病死率分别为46%和36%，两组相比差异有显著意义（P＜0.01、P＜0.05）。延期手术组中，无明显感染者其并发症发生率和病死率明显低于有严重感染及重要器官功能不全者（P＜0.01、P＜0.05）。　结论　早期手术治疗对于一些重症胰腺炎患者仍然是必需的。胰腺坏死广泛者宜在发生严重感染前进行手术。
목적　탐토중증이선염적수술지정화수술시궤。　방법　회고성분석82례중증이선염적치료정황，기중행비수술치료10례、조기수술44례、연기수술28례。　결과　본조총병발증발생솔위24％、총병사솔위18％。비수술조10례균전유，병발증발생솔위10%；조기수술조사망5례，병발증발생솔화병사솔분별위14%화11%；연기수술조사망10례，병발증발생솔화병사솔분별위46%화36%，량조상비차이유현저의의（P＜0.01、P＜0.05）。연기수술조중，무명현감염자기병발증발생솔화병사솔명현저우유엄중감염급중요기관공능불전자（P＜0.01、P＜0.05）。　결론　조기수술치료대우일사중증이선염환자잉연시필수적。이선배사엄범자의재발생엄중감염전진행수술。
Objective　 To investigate the indication and timing of surgery for acute necrotizing pancreatitis.　 Methods　 82 cases of acute necrotizing pancreatitis were analyzed retrospectively. 10 cases were treated non-operatively. Early operation was performed on 44 cases, while 28 cases underwent surgery on late stage.　 Results　 The overall morbidity and mortality was 24% and 18%, respectively. All 10 patients in the non-operative group were cured with a morbidity of 10%. The morbidity and mortality in the early operation group was 14% and 11%, respectively, compared with 46% and 36% of those receiving surgery on late stage（P＜0.01, P＜0.05）. Among those in late surgery group, patients not complicating infection had significant lower morbidity and mortality rate than those suffering from severe infection or organ dysfunction（P＜0.01, P＜0.05）.　 Conclusions　 Early operation is necessary for some severe cases.In patients with severe pancreatic necrosis surgery should be performed before severe infection occurs.