摘要：目的：探讨分析重症急性胰腺炎(SAP)手术治疗与非手术治疗的利弊，以便制订更科学的治疗方法，减少并发症发生率及死亡率，提高疗效。方法：通过对本院近18年来147例重症急性胰腺炎患者手术治疗与非手术治疗的治疗效果进行分析。结果：手术治疗65例，其中早期手术39例，并发症发生率及病死率分别为69.2%及48.7%，延期手术26例，并发症发生率及病死率分别为42.3%及34.6%，非手术治疗82例，并发症发生率及病死率分别为40.2%及29.3%。结论：手术治疗及非手术治疗对SAP均有其利弊，不能片面夸大非手术治疗的作用而忽视手术治疗，应遵循“个体化治疗”的原则，对无明显手术指征的病例先行积极的非手术治疗，密切观察，对有手术指征的患者要把握手术时机，适时手术。

    关键词：重症急性胰腺炎；治疗

    Research on the advantages and Disadvantages of Operative or Non-operative treatments for Severe acute Pancreatitis

    LI Ting-han,WU Zhu-dong,CHEN Wei-rong,et al

    (The Second Affiliated Hospital to Shantou University Medical College, Guangdong Shantou 515000, China)

    Abstract： Objective：To explore the advantages and disadvantages of operative or non-operative treatments for severe acute pancreatitis (SAP).The aim of this study is to work out a more scientific therapy and reduce the incidence of complications and mortality for patients with SAP. Method： The therapeutic effects of 147 patients with SAP who received operative or nonoperative treatments in our hospital were analyzed. Result： The incidence of complications and mortality were 42.3% and 48.7% respectively in early operating treatment group (n=39), while 40.2% and 34.6% respectively in postponed operating treatment group (n=26).The incidence was 40.2% and 29.3% respectively in those receiving non-operative treatments (n=86). Conclusion： Operative or non-operative treatment of SAP patients has its own advantages and disadvantages. Unilaterally magnify the effects of non-operative treatment and neglect operative one is not true. Principle of individualized treatment should be followed. When patients without obvious indications for operation, energetic non-operative treatments and carefully care should be employed. Operation should be carried out in time when indications for operation comes. ......