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目的总结对重症急性胰腺炎的中西医结合治疗并就手术时机进行探讨。方法对2001年1月-2010年7月收治的32例重症急性胰腺炎进行回顾性分析。其中20例采用中西医结合保守治疗1,2例行手术治疗。中西医结合保守治疗是在予以严密监护,禁食,胃肠减压,抑制胰腺分泌药物应用,改善微循环,静脉营养,联合抗生素应用,维持水电解质及酸碱平衡等常规西医治疗基础上加用中药复方清胰汤胃内灌注或复方大承气汤灌肠。结果 32例采用中西医结合保守治疗20例,无一例死亡。手术治疗12例,死亡2例,余均痊愈。随访,保守治疗的患者1例出现胰腺假性囊肿,另一例出院1月后再次发生胰腺炎,余无并发症。结论重症急性胰腺炎大部分可通过中西医结合保守治疗获得痊愈,小部分需急诊手术或在保守治疗过程中严密监测,根据病情把握手术时机,及时手术。
Objective To summarize the integrative treatment of severe acute pancreatitis and to discuss the timing of the operation. Methods 32 cases of severe acute pancreatitis admitted from January 2001 to July 2010 were retrospectively analyzed. Among them, 20 cases were treated conservatively with traditional Chinese and western medicine in 1 and 2 cases. Conservative treatment of traditional Chinese and Western medicine is to be closely monitored, fasting, gastrointestinal decompression, inhibition of pancreatic secretion of drug use, improve microcirculation, intravenous nutrition, combined antibiotic use, to maintain water and electrolyte and acid-base balance on the basis of conventional Western medicine plus Qingyitang with traditional Chinese medicine compound recipe stomach or compound Dachengqi enema. Results 32 cases of conservative treatment of Integrative Medicine in 20 cases, no case of death. Surgical treatment in 12 cases, 2 patients died, I were cured. Follow-up, conservative treatment of pancreatic pseudocyst occurred in 1 case, another case of pancreatitis after discharge in January, more than no complications. Conclusion Most of severe acute pancreatitis can be cured by conservative treatment of traditional Chinese medicine and western medicine. A small number of patients need emergency operation or close monitoring during conservative treatment. According to the condition, timely operation and timely operation are obtained.