老年人重症急性胆源性胰腺炎的中西医结合治疗临床分析

目的总结中西医结合治疗老年人重症急性胆源性胰腺炎的疗效,并对手术的时机进行探讨。方法2000年1月—2007年12月,采用中西医结合治疗老年重症急性胆源性胰腺炎96例(中西医组),采用常规西医治疗组32例(西医组),分析两组患者的住院时间、并发症发生率、中转手术率和病死率。结果(1)西医组平均住院时间为(32.7±14.3)天,中西医组为(28.2±11.3)天,两组比较,差异无统计学意义(P>0.05);(2)并发症发生率:早期并发症西医组为34.4%(11/32),中西医组29.2%(28/96),两组比较,差异无统计学意义(P>0.05);后期并发症发生率西医组53.1%(17/32),中西医组为36.5%(35/96),中西医组低于西医组(P<0.05)。(3)手术率:西医组为43.8%(14/32),中西医组为36.4%(35/96),两组比较,差异无统计学意义(P>0.05)。(4)病死率:西医组为37.5%(12/32),中西医组为21.9%(21/96),中西医组病死率低于西医组(P<0.05)。结论中西医结合治疗重症急性胆源性胰腺炎取得较好疗效,应根据是否有胆道梗阻来确定手术时机。

英文摘要:

Objective To summarize the therapeutic effect of integrated traditional Chinese and Western medicine(ICWM) on severe acute biliary pancreatitis(SABP),and to discuss the opportunity of operation.MethodsThe hospitalization duration,incidence of complications,operation transmitting rate and mortality were analyzed in 96 senile SABP patients(Group A) treated by ICWM,and 32 senile SABP patients treated by conventional Western medicine,they were hospitalized from January 2000 to December 2007.Results(1) The average hospitalization duration in Group A and B was 28.2±11.3 days and 32.7±14.3 days respectively,showing insignificant difference between them(P>0.05);(2) The early stage incidence of complications being 29.2%(28/96) in Group A and 34.4%(11/32) in Group B,no significant difference between groups was shown,but a significant difference did show at the late stage,36.5%(35/96) vs 53.1%(17/32),the incidence in Group A was lower significantly(P<0.05).(3) The two groups were not different in operation transmitting rate 36.4%(35/96) vs 43.8%(14/32),P>0.05.(4) The mortality in Group A,21.9%(21/96) was lower than that in Group B,37.5%(12/32),P<0.05.ConclusionICWM has good effect in treating SABP,and the opportunity of operation transmitting should be decided according to whether there obstruction of biliary tract exists or not.

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