Sun Bei, Zhou Hao-xin, Li Jun, Wang Gang, Liu Jie, Wu Lin-feng, Li Pang-quan, Zhao Ming-yan, Yang You-lin, Jiang Hong-chi
Department of Pancreas and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University, China.
Zhonghua Wai Ke Za Zhi. 2010 Sep 15;48(18):1383-6.
To summary the experience of the surgical comprehensive treatment of severe acute pancreatitis (SAP).
From July 1999 to December 2009, a total of 506 patients suffered SAP were admitted with a mean APACHE II score 12.8 ± 4.6. There were 270 male and 236 female, aged from 16 to 89 years, mean age 43 years. SAP patients were treated by the SAP treatment team which consisted of pancreatic specialized and multidisciplinary doctors. Two hundreds and thirty-four cases (46.2%) received non-operative treatment and 272 cases (53.8%) received surgical intervention.
In 506 cases, 445 patients were cured and 52 patients died (31 died in early stage, 21 died in later stage), 9 cases discharged automatically. The overall incidence of complication, overall mortality and overall curative rate were 29.4% (149/506), 10.3% (52/506) and 87.9% (445/506), respectively. The incidences of complication in non-operative group and in surgical intervention group were 27.8% (65/234) and 30.9% (84/272), respectively (P > 0.05). The mortality in non-operative group and in surgical intervention group were 9.4% (22/234) and 11.0% (30/272), respectively (P > 0.05). The curative rates in non-operative group and in surgical intervention group were 90.6% (212/234) and 85.7% (233/272), respectively (P > 0.05).
Patients should be treated in ICU in the early phase of the disease when APACHE II score > 10. Pancreatic specialized and multidisciplinary team treatment, appropriate choice of timing, indication and procedure of surgical intervention and details of drainage are vital to the prognosis of SAP.
总结重症急性胰腺炎（SAP）外科综合治疗的经验。
1999年7月至2009年12月，共收治506例SAP患者，急性生理与慢性健康状况评分系统（APACHE II）平均评分为12.8±4.6。其中男性270例，女性236例，年龄16～89岁，平均年龄43岁。SAP患者由胰腺专科医生和多学科医生组成的SAP治疗团队进行治疗。234例（46.2%）接受非手术治疗，272例（53.8%）接受手术干预。
506例患者中，445例治愈，52例死亡（31例死于早期，21例死于后期），9例自动出院。并发症总发生率、总死亡率和总治愈率分别为29.4%（149/506）、10.3%（52/506）和87.9%（445/506）。非手术组和手术干预组并发症发生率分别为27.8%（65/234）和30.9%（84/272）（P>0.05）。非手术组和手术干预组死亡率分别为9.4%（22/234）和11.0%（30/272）（P>0.05）。非手术组和手术干预组治愈率分别为90.6%（212/234）和85.7%（233/272）（P>0.05）。
当APACHE II评分>10时，患者在疾病早期应入住重症监护病房（ICU）。胰腺专科和多学科团队治疗、手术干预时机、适应证和手术方式的恰当选择以及引流细节对SAP的预后至关重要。
