Cochior D, Constantinoiu S, Peţa D, Bîrlă R, Pripişi L, Hoară P
Clinica de Chirurgie, Spitalului Clinic CF 2, Bucureşti.
Chirurgia (Bucur). 2010 May-Jun;105(3):339-46.
The management in severe acute pancreatitis evolved in the last two decades. Consulting the literature and the accumulated clinical experience manage to the release of this study based on the comparison of the treatment in PAS between two distinct periods: 1994-1999 (retrospective) and 2000-2007 (prospective). Among the 285 patients whit PAS admitted and treated in the two departments, 224 (78.6%) was submitted to the surgical intervention with various surgical indications. There is an obvious difference between the retrospective and prospective studies concerning the indication of surgery and mostly the timing for surgery. The lots were analyzed concerning the etiology, management of treatments and specific treatments, and the timing of the surgical intervention was analyzed based on the specific etiologic treatment and the period of time between the admission and the first surgical intervention, the mark being the 21 day according with the recommendations of the International Association of Pancreatology. There were analyzed: the period of time between the onset of the disease and the surgical intervention, the status of the patients at the surgical moment, the global mortality based on the timing of surgery, the evolution of the management of PAS along the period of the research, comparisons whit the literature. The registered data were statistically processed using the SPSS test version 17 for Windows.
在过去二十年中,重症急性胰腺炎的治疗方法不断演变。参考相关文献及积累的临床经验,基于对两个不同时期(1994 - 1999年,回顾性研究;2000 - 2007年,前瞻性研究)胰腺炎治疗情况的比较,开展了本项研究。在两个科室收治并接受治疗的285例胰腺炎患者中,224例(78.6%)因各种手术指征接受了手术干预。回顾性研究与前瞻性研究在手术指征尤其是手术时机方面存在明显差异。对病例组进行了病因、治疗管理及特殊治疗分析,并根据特定病因治疗及入院至首次手术干预的时间间隔(按照国际胰腺病协会的建议,以21天为节点)对手术干预时机进行了分析。分析内容包括:发病至手术干预的时间间隔、手术时患者的状况、基于手术时机的总体死亡率、研究期间胰腺炎治疗管理的演变、与文献的比较。使用适用于Windows系统的SPSS 17.0版软件对记录的数据进行统计学处理。