Control Study of Treatments for Severe Acute Pancreatitis During Different Periods_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAO Xinmin , ZHANG Shu , LI Yuntao , HUANG Dequan , WEN Jun , YANG Yicun , CAO Yang , YU Lan , PENG Qiusheng , HU Xiandian , GONG Rong , XU Chiwei.

Department of General Surgery, The Third People’s Hospital of Chengdu City, Chengdu 610031, Sichuan Province, China;

Corresponding author：

Keywords：

Severe acute pancreatitis; Therapeutic mode; Control study

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ObjectiveTo evaluate the therapic efficacy for severe acute pancreatitis (SAP) during different periods. MethodsAccording to internalized standard, 234 patients with SAP admitted to this hospital from January 1986 to October 2009 were included, which were divided into two stages based on the time of admitting to this hospital. The first stage named prior operation group was from January 1986 to August 1998 (n=117), the second stage named individual treatment group was from September 1998 to October 2009 (n=117). There was comparability in demography and clinic between two groups. The prior operation group primarily underwent laparotomy and medication, and the individual treatment group underwent multiple combined therapies. These indexes were compared between two groups: hospital stay, cure rate, and mortality; the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, acute renal failure (ARF), acute respiratory distress syndrome (ARDS), and shock. The efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications were compared two groups by stratified analysis. ResultsCompared with the prior operation group, the hospital stay was shorter (P lt;0.05), cure rate was higher (P lt;0.001), and mortality was lower in the individual treatment group (P lt;0.001). During the treatments, the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, ARF, ARDS, and shock in the individual treatment group were lower than those in the prior operation group (P lt;0.05). According to the stratified analysis, the efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications in the individual treatment group were better than those in the prior operation group (P lt;0.001). ConclusionIn recent years, the change of therapeutic mode significantly improves the treatment efficacy for SAP.

Citation： YAO Xinmin,ZHANG Shu,LI Yuntao,HUANG Dequan,WEN Jun,YANG Yicun,CAO Yang,YU Lan,PENG Qiusheng,HU Xiandian,GONG Rong,XU Chiwei.. Control Study of Treatments for Severe Acute Pancreatitis During Different Periods. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(3): 245-249. doi: Copy

1.	中华医学会外科学分会胰腺外科学组. 重症胰腺炎诊治指南 [J]. 中华外科杂志, 2007, 45(11): 727729.
2.	黄江涛, 姚欣敏. 区域动脉灌注治疗重症急性胰腺炎 [J]. 四川医学, 2002, 23(6): 602603.
3.	张抒, 罗静, 姚欣敏, 等. 体外药盒置入胰腺区域动脉灌注治疗重症急性胰腺炎30例临床分析 [J]. 中国普外基础与临床杂志, 2003, 10(6): 545547.
4.	黄江涛, 姚欣敏, 曹扬, 等. 体外药盒置入胰腺区域动脉灌注治疗重症急性胰腺炎临床研究 [J]. 实用医院临床杂志，2009, 6(2): 8788.
5.	姚欣敏, 刘牧, 李云涛, 等. 早期反复间断血滤治疗重症急性胰腺炎的临床研究 [J]. 中国普外基础与临床杂志, 2008, 15(5): 352357, 361.
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7.	于澜, 姚欣敏, 胡先典, 等. 经内镜治疗急性胆源性胰腺炎临床研究 [J]. 四川医学, 2009, 30(5): 707709.
8.	黄江涛, 胡先典. 腹腔镜下置管灌洗引流在重症急性胰腺炎早期治疗中的体会 [J]. 四川医学, 2007, 28(4): 419421.
9.	黄江涛, 姚欣敏. 早期腹腔引流在重症急性胰腺炎治疗的应用价值 [J]. 中国医药导刊, 2010, 12(3): 398399.
10.	罗静, 彭秋生, 姚欣敏. CT引导下经皮穿刺引流诊治急性胰腺炎局部并发症-附23例报告 [J]. 胰腺病学, 2007, 7(4): 251252.
11.	姚欣敏, 于澜, 张抒, 等. CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究(附43例报道) [J]. 中国普外基础与临床杂志, 2008, 15(8): 560563, 566.
12.	许持卫, 吕海波, 周翔平. CT引导下经皮急性胰腺炎急性液体聚集穿刺置管引流术 [J]. 实用放射学杂志, 2008, 24(2): 209210, 214.
13.	袁祖荣, 张臣烈, 汤跃卿, 等. 急性坏死性胰腺炎外科治疗20年经验总结 [J]. 中华外科杂志, 1977, 35(3): 132134.
14.	Rinderknecht H. Fatal pancreatitis, a consequence of excessive leukocyte stimulation? [J]. Int J Pancreatol, 1988, 3(23): 105112.
15.	Banerjee AK, Steele RJ. Current views on the pathophysiology of acute biliary pancreatitis [J]. Gut, 1995， 36(6): 803805.
16.	周蒙滔, 张启瑜, 王春友, 等. 区域动脉灌注治疗重症急性胰腺炎45例临床研究 [J]. 中国实用外科杂志, 2009, 10(29): 850852.
17.	Hayashi J, Kawarada Y, Isaji S, et al. Therapeutic effects of continuous intraarterial antibiotic infusion in preventing pancreatic infection in experimental acute necrotizing pancreatitis [J]. Pancreas, 1996, 13(2): 184192.
18.	孔瑞, 孙备. 重症急性胰腺炎微创治疗的研究进展 [J]. 国外医学外科学分册, 2005, 32(6): 426429.
19.	姚欣敏, 李云涛, 黄德全, 等. 多种微创方法联合个体化治疗重症急性胰腺炎 [J]. 中国普外基础与临床杂志, 2010, 17(6): 586590.

1. 中华医学会外科学分会胰腺外科学组. 重症胰腺炎诊治指南 [J]. 中华外科杂志, 2007, 45(11): 727729.
2. 黄江涛, 姚欣敏. 区域动脉灌注治疗重症急性胰腺炎 [J]. 四川医学, 2002, 23(6): 602603.
3. 张抒, 罗静, 姚欣敏, 等. 体外药盒置入胰腺区域动脉灌注治疗重症急性胰腺炎30例临床分析 [J]. 中国普外基础与临床杂志, 2003, 10(6): 545547.
4. 黄江涛, 姚欣敏, 曹扬, 等. 体外药盒置入胰腺区域动脉灌注治疗重症急性胰腺炎临床研究 [J]. 实用医院临床杂志，2009, 6(2): 8788.
5. 姚欣敏, 刘牧, 李云涛, 等. 早期反复间断血滤治疗重症急性胰腺炎的临床研究 [J]. 中国普外基础与临床杂志, 2008, 15(5): 352357, 361.
6. 于澜, 姚欣敏, 胡先典, 等. 经内镜治疗急性胆源性胰腺炎30例报道 [J]. 中国普外基础与临床杂志, 2007, 14(4): 396398.
7. 于澜, 姚欣敏, 胡先典, 等. 经内镜治疗急性胆源性胰腺炎临床研究 [J]. 四川医学, 2009, 30(5): 707709.
8. 黄江涛, 胡先典. 腹腔镜下置管灌洗引流在重症急性胰腺炎早期治疗中的体会 [J]. 四川医学, 2007, 28(4): 419421.
9. 黄江涛, 姚欣敏. 早期腹腔引流在重症急性胰腺炎治疗的应用价值 [J]. 中国医药导刊, 2010, 12(3): 398399.
10. 罗静, 彭秋生, 姚欣敏. CT引导下经皮穿刺引流诊治急性胰腺炎局部并发症-附23例报告 [J]. 胰腺病学, 2007, 7(4): 251252.
11. 姚欣敏, 于澜, 张抒, 等. CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究(附43例报道) [J]. 中国普外基础与临床杂志, 2008, 15(8): 560563, 566.
12. 许持卫, 吕海波, 周翔平. CT引导下经皮急性胰腺炎急性液体聚集穿刺置管引流术 [J]. 实用放射学杂志, 2008, 24(2): 209210, 214.
13. 袁祖荣, 张臣烈, 汤跃卿, 等. 急性坏死性胰腺炎外科治疗20年经验总结 [J]. 中华外科杂志, 1977, 35(3): 132134.
14. Rinderknecht H. Fatal pancreatitis, a consequence of excessive leukocyte stimulation? [J]. Int J Pancreatol, 1988, 3(23): 105112.
15. Banerjee AK, Steele RJ. Current views on the pathophysiology of acute biliary pancreatitis [J]. Gut, 1995， 36(6): 803805.
16. 周蒙滔, 张启瑜, 王春友, 等. 区域动脉灌注治疗重症急性胰腺炎45例临床研究 [J]. 中国实用外科杂志, 2009, 10(29): 850852.
17. Hayashi J, Kawarada Y, Isaji S, et al. Therapeutic effects of continuous intraarterial antibiotic infusion in preventing pancreatic infection in experimental acute necrotizing pancreatitis [J]. Pancreas, 1996, 13(2): 184192.
18. 孔瑞, 孙备. 重症急性胰腺炎微创治疗的研究进展 [J]. 国外医学外科学分册, 2005, 32(6): 426429.
19. 姚欣敏, 李云涛, 黄德全, 等. 多种微创方法联合个体化治疗重症急性胰腺炎 [J]. 中国普外基础与临床杂志, 2010, 17(6): 586590.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Control Study of Treatments for Severe Acute Pancreatitis During Different Periods

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