【摘要】 目的 探讨重症急性胰腺炎(SAP)的治疗，主要关于手术时机的掌握及手术方式的选择。方法 对112例SAP病例的临床资料进行回顾性分析。结果 112例病例中，26例患者在病程不同阶段中转手术，因胰腺感染而手术共18例其中感染未局限者5例中3例死亡，感染局限手术者13例全部存活。后者死亡率明显降低。结论 重症急性胰腺炎在早期应以保守治疗为主，较早出现严重感染或ARDS，或者明确有胆道疾病存在者考虑手术。而病程延期至全身情况稳定后，应手术清除胰周坏死组织并引流。

    【关键词】 重症急性胰腺炎；感染；手术指征

    Analysis of optimizing timing for severe acute pancreatitis

    ZHAO Jia-lin,GUO Shan-yu.

    Department of General Surgery,The Ninth People’s Hospital,Shanghai Second Medical University,Shanghai 200011,China

    【Abstract】 Objective The research is designed to analyze some important questions in the treatment of severe acute pancreatitis(SAP).In this article,surgical indications are mainly discussed.Methods A certain retrospective analysis of 112 SAP patients was completed.

    Results 26 patients out of 112 cases were operated during different stages of SAP.3 patients who had uncontrolled infection died,while all patients whose infection were controlled survived.Mortality rate of the later declined markedly.Conclusion In early stage of SAP,the therapy should be non-operative except those who commit severe infection,ARDS or bile duct obstruction.In later stage,operations are required to remove clearly the necrotic tissues and effective drainage should be done. ......