CAJ | 학술논문

目的:分析急性坏死性胰腺炎(ANP)术后死亡的原因,探讨ANP的手术指征和合理的手术方式.方法:将手术治疗ANP112例分成死亡组和存活组,对有关预后的指标进行对比和统计学分析.结果:两组病人的平均年龄、性别比例和起病时间比较接近,早期休克、成人呼吸窘迫综合症(ARDS)、发热、血象和高血糖的发生率在两组间没有明是差异(P均＞0.05).与死亡有关的主要因素有:①胰腺的坏死程度;②手术方式不正确;③手术指征不妥.结论:轻、中度ANP应该首先试行非手术治疗48～72h.术前早期休克和ARDS应该及时纠正.术中应该充分游离肿胀的胰腺,有利于术后充分引流.建议行十二指肠造口术.
목적:분석급성배사성이선염(ANP)술후사망적원인,탐토ANP적수술지정화합리적수술방식.방법:장수술치료ANP112례분성사망조화존활조,대유관예후적지표진행대비화통계학분석.결과:량조병인적평균년령、성별비례화기병시간비교접근,조기휴극、성인호흡군박종합증(ARDS)、발열、혈상화고혈당적발생솔재량조간몰유명시차이(P균＞0.05).여사망유관적주요인소유:①이선적배사정도;②수술방식불정학;③수술지정불타.결론:경、중도ANP응해수선시행비수술치료48～72h.술전조기휴극화ARDS응해급시규정.술중응해충분유리종창적이선,유리우술후충분인류.건의행십이지장조구술.
Objective:To investigate the reasonable approach and surgical indication for acute necrotizing pancreatitis(ANP)by analyzing the factors that affecting the mortality of ANP.Methods:One hundred and twelve patients with ANP were retrospectively divided into two groups-the dead and the survivors.Some parameters were analyzed statistically to reveal what's the reason for death.Results:The average age,sex ratio and onset of illness were similar between two groups.And the ratio of early shock,early adult respiratory distress syndrome (ARDS),high temperature,leukocytosis and high blood glucose between two groups were also similar between two groups(P＞0.05,respectively).The important factors that affecting the mortality were:①severity of pancreatic necrosis,②improper surgical approach,③incorrect surgical indication.Conclusion:The patiets with mild or moderate ANP should mainly receive conservative treatment for 48～72 hours.The early shock and ARDS should be redressed before surgical intervention.If the operation is unavoidable,the swelling pancreas should be dissected fully,which will provide sufficient drainage after operation,and duodenostomy should be performed during operation.