【摘要】 目的 探讨重症急性胰腺炎(severe acute pancreatitis,SAP)并发急性肾功能衰竭(acute renal failure,ARF)的诱发因素和防治方法。方法根据Ranson系列预后判断标准和APACHEⅡ评分,结合影像学和病理学检查(手术病例),将我院274例急性胰腺炎患者分为:轻型AP组(A组)(182例),SAP非手术治疗组(B组)(54例)和手术治疗组(C组)(38例),取同期不伴急性炎症的胆囊结石患者80冽为对照组。研究各组血清生化检验结果和治疗、预后:结果B组和C组平均血钾、血尿素氮和肌酐高于对照组和A组(P<0.01),A组患者的各项指标高于对照组(P<0.05),SAP患者腹腔内渗液量与ARF严重程度呈正相关关系(r=0.33.p<0.05)。结论ARF是SAP致命性的严重并发症,尽早明确SAP诊断、及时手术治疗、切实可靠的引流,是防治SAP并发ARF,改善预后的重要手段。更多还原

【Abstract】 Objective To discuss the cause of severe acute pancreatitis (SAP) complicated by acute renal failure (ARF), and the methods of precaution and therapy.Methods 274 patients with acute pancreatitis and 80 normal controls were recruited into the study.We classified controls group, mild acute pancreatitis (AP) patients was A group,SAP treated by un-operation patients was B group and those by operation patients was C group by methods of evaluation (Ranson and APACHE Ⅱ ) combined gravure and pathology.Retrospective analysis was made on biochemical examination in serum, and the result of surgical treatment of AP patients.Results The level of serum K+, BUN,SCR for patients in B group and C group were higher than that in controls group and A group (P<0.01) .In A group, these results were higher than those in controls group (P<0.05) .Linear correlation was demonstrated between the strictness degree of ARF and the quantity of fluid in abdominal cavity with SAP patients (r=0.33,P<0.05) . Conclusions The ARF was a severe and deadly complication with SAP.We must take a specific diagnose against time and adopt a decided operation most advisable.These were the methods of precaution and therapy effective.更多还原