急性胆源性胰腺炎68例外科治疗分析(1)
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[摘要] 目的：探讨急性胆源性胰腺炎的外科治疗方法。方法：随机选取来本院进行诊治的急性胆源性胰腺炎患者68例，并对其临床资料进行回顾性分析。结果：经临床分析得知，68例急性胆源性胰腺炎患者中，轻症胰腺炎患者63例，对6例急诊患者行胆囊切除、胆总管切开取石等治疗，病情均好转，保守治疗57例，待病情缓解后实施剖腹或腹腔镜胆囊切除术或胆总管切开取石T管引流术，均痊愈；重症患者5例，均对其进行急诊治疗，2例死亡。结论：临床对急性胆源性胰腺炎患者进行治疗时，应对患者的病情作出正确判断，同时根据患者病情的严重程度，制定相应的治疗方案，合理实施手术，以保证患者的生命安全。
[关键词] 急性胆源性胰腺炎；外科；胆囊切除；轻症；重症
[中图分类号] R576 [文献标识码] A [文章编号] 1674-4721(2011)11(c)-036-02
Analysis of surgical treatment in 68 cases with acute biliary pancreatitis
CHEN Zhijun, ZHOU Huafang
The Fifth People′s Hospital of Yuanjiang City, Hunan Province, Yuanjiang 413100, China
[Abstract] Objective: To discuss the surgical treatment in acute biliary pancreatitis. Methods: Randomly chose 68 patients with acute biliary pancreatitis diagnosed and treated in our hospital, and took the retrospective analyzed of clinical data. Results: According to the clinical analyzed, there were 63 cases with mild pancreatitis among 68 cases with acute biliary pancreatitis. 6 emergency patients received treatments of cholecystectomy and choledocholithotomy, with rapid progress of disease. 57 cases received conservative treatment, who took open or laparoscopic cholecystectomy or choledocholithotomy T-tube drainage after disease-modifying, all recovered. 5 critical patients received emergency treatment, 2 cases died. Conclusion: We have to take the correct diagnosis of diseases when treating patients with acute biliary pancreatitis clinically, and make the corresponding treatment plan and take the reasonable operation according to the degree of diseases, in order to guarantee the life safety of patients.
[Key words] Acute biliary pancreatitis; Surgical treatment; Cholecystectomy; Mild; Severe
急性胆源性胰腺炎是外科常见的急腹症之一，其发生原因较为复杂，可由于各种胆道疾病，包括胆管结石、胆道蛔虫及胆道感染等所引起。此病症发病较快，且病情发展迅速，如不及时进行治疗，死亡率极高，严重影响患者的身心健康。针对这一特点，临床在对其进行治疗时，应选择合适的治疗方案，及时诊断，及时治疗[1]。将本院68例急性胆源性胰腺炎患者的临床资料进行回顾性分析，现报道如下：
1 资料与方法
1.1 一般资料
随机选取2009年1月～2010年1月来本院进行诊治的急性胆源性胰腺炎患者68例，男41例，女27例，年龄32～76岁。所有患者经临床诊断分别有不同程度的上腹部疼痛、恶心、呕吐、腹胀、血尿淀粉酶增高；胆道结石、胰腺坏死分别经B超、CT检查或剖腹手术予以证实。本组轻症急性胆源性胰腺炎患者63例，重症急性胆源性胰腺炎患者5例。68例急性胆源性胰腺炎患者中，轻症胰腺炎患者63例。
1.2 方法
对6例急诊患者行胆囊切除、胆总管切开取石等治疗，保守治疗57例，待病情缓解后实施剖腹或腹腔镜胆囊切除术或胆总管切开取石T管引流术；重症患者5例，均对其进行急诊治疗。
1.3 疗效评定
68例急性胆源性胰腺炎患者均根据中华医学会外科学会1997年拟订的“急性胰腺炎的临床诊断及分类标准”确诊 ......
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