Strategy to improve successful treatment for severe acute pancreatitis

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Author:
DI Jian-zhong(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
HAN Xiao-dong(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
ZHANG Hong-wei(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
DU Yi-bao(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
ZHANG Pin(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
ZHENG Qi(Department of Surgery, Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 10, Issue 03, 2010
DOI:
10.3760/cma.j.issn.1674-1935.2010.03.006
Key Word:
Pancreatitis, acute necrotizing;Therapy;Case control studies;Drug therapy;Surgical procedures ,operative

Abstract: Objective To investigate the strategy to improve successful treatment for severe acute pancreatitis (SAP). Methods The study period was divided into from 1992 to 2000, and from 2001 to 2009.The patients during these two phases were comparable as regard to sex and age. Results The proportion of patients received anti-inflammatory medications from 2001 to 2009 was 88.7% (94/106), medications which can improve the pancreatic microcirculation were used in 93.4% (99/106), early enteral nutrition was used in 58.5% (62/106), medications which can protect intestinal barrier function were used in 98.1% ( 104/106),all these parameters were significantly higher than those (22.4%, 19/85; 43.5%, 37/85; 29.4%, 25/85;17.7%,15/85) from 1992 to 2000. Also from 1992 to 2000, more patients underwent operation such as basin-shaped open drainage, pancreatic necrosis debridement. While more patients underwent operation such as laparoscopic drainage, CT or B-ultrasound guided percutaneous drainage from 2001 to 2009. The proportion of patients underwent surgical treatment decreased from 56.5% (48/85) to 32. 1%(34/106); the survival rate increased from 68.8% to 84.0%. Conclusions The research progress of medications was the foundation to improve successful treatment for SAP. Operation was an important option during SAP therapy. The individualized treatment was beneficial to improve successful treatment for SAP.

  • [1]雷若庆,吴旭波,田锐,等.暴发性急性胰腺炎的外科治疗策略探讨.外科理论与实践,2005,10:56-60.
  • [2]王春友.提高对重症急性胰腺炎多脏器功能障碍的认识及防治水平.中国实用外科杂志,2006,26:328-330.
  • [3]Appelros S,Borgst(o)m A,Lindgren S.Short and long term outcome of severe acute pancreatitis.Eur J Surg,2001,167:281-286.
  • [4]黄志强.微创外科与外科"进化论".中华腔镜外科杂志,2009,2:1-2.
  • [5]中华医学会消化病学分会胰腺病学组.中国急性胰腺炎诊治指南(草案).胰腺病学,2004,4:35-38.
  • [6]张圣道.重症急性胰腺炎"个体化治疗方案"评估.临床外科杂志,2004,12:18-19.
  • [7]Kouraklis G,Spirakos S,Glinavou A.Damage control surgery:an alternative approach for the management of critically injured patients.Surg Today,2002,32:195-202.
  • [8]孙备,姜洪池,许军,等.重症急性胰腺炎外科干预的时机、指征与方式选择.中国实用外科杂志,2005,25:414-416.
  • [9]黎沾良.严重创伤的损伤控制性手术.中国实用外科杂志,2006,26:909-910.
  • [10]郑起.急性坏死性胰腺炎并发四肢末梢坏死一例.中华普通外科杂志,2000,15:721.
  • [11]刘付宝,耿小平,赵红川,等.重症急性胰腺炎手术时机和手术入路的选择.肝胆外科杂志,2009,17:336-338.
  • [12]区金锐,侯宝华.分期微创手术方式在重症急性胰腺炎外科治疗中的应用.中国实用外科杂志,2006,26:61-62.
  • [13]狄建忠,张频,戴坤扬.腹腔镜法治疗暴发性胰腺炎一例.临床外科杂志,2002,10:155.
  • [14]汤礼军,汪涛,田伏洲,等.置管引流并胆道镜清创治疗重症急性胰腺炎继发的胰腺及胰周感染22例体会.中国实用外科杂志,2009,29:425-427.
  • [15]狄建忠,张频,郑起.急性呼吸窘迫综合征在重症急性胰腺炎治疗过程中的临床意义.临床消化病杂志,2007,19:226-227.
  • [16]李维勤.重症急性胰腺炎病人营养模式的变迁.肝胆外科杂志,2009,17:328-329.
  • [17]虞文魁,李维勤,童智慧,等.早期特重型胰腺炎的临床特点和疗效分析.中华肝胆外科杂志,2008,14:95-98.
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