Shevchuk I M, Kuzenko R T
Klin Khir. 2013 Nov(11):27-30.
The results of treatment of 99 elderly and senile patients, suffering an acute pancreatitis in period of 2005 - 2013 yrs, were analyzed. Interstitial acute pancreatitis was diagnoses in 36 (36.3%) patients, focal pancreatic necrosis--in 32 (32.3%), total-subtotal pancreonecrosis--in 31 (31.3%). Miniinvasive interventions were performed in 40 (63.4%) patients, the open--in 24 (38%). The main indication for laparotomy conduction were purulent-septic complications, which is impossible to eliminate while miniinvasive methods application. Due to application of the staged treatment tactics with predominant application of miniinvasive methods, extracorporeal detoxication and improvement of the intensive therapy measures postoperative lethality in necrotic acute pancreatitis have had lowered from 16.7 to 10.3%.
对1995 - 2013年期间99例患有急性胰腺炎的老年和高龄患者的治疗结果进行了分析。36例(36.3%)患者诊断为间质性急性胰腺炎,32例(32.3%)为局灶性胰腺坏死,31例(31.3%)为全胰腺或次全胰腺坏死。40例(63.4%)患者进行了微创干预,24例(38%)进行了开放手术。剖腹手术的主要指征是化脓性败血症并发症,在应用微创方法时无法消除。由于采用了以微创方法为主的分期治疗策略、体外解毒以及强化治疗措施的改进,坏死性急性胰腺炎的术后死亡率从16.7%降至10.3%。