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重症急性胰腺炎非手术治疗临床分析

Clinical analysis on patients with severe acute pancreatitis treated by non-surgical therapy

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【作者】 何智辉伍国宝程宗勇

【Author】 HE Zhi-hui1, WU Guo-bao1, CHENG Zong-yong2(1. Department of Intensive Care Unit, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R.China; 2. Department of Gastroenterology, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R.China)

【机构】 中南大学湘雅二医院ICU中心中南大学湘雅二医院消化科 湖南长沙410008湖南长沙410008湖南长沙410008

【摘要】 目的观察非手术治疗重症急性胰腺炎(severeacutepancreatitis,SAP)的治疗效果。方法采用回顾性总结方法,分析该院ICU中心近年所收治的接受非手术治疗的重症急性胰腺炎患者的相关指标和预后,分为死亡组和好转组。结果两组在急性生理学变量分值、APACHEⅡ评分方面差异有显著性,而在既往健康状况分值、年龄方面差异无显著性。总死亡率47.83%(11/23),而入院1周内死亡患者占总死亡患者的54.55%(6/11)。死亡患者中54.55%(6/11)死于多器官功能衰竭。结论APACHEⅡ评分是估计接受非手术治疗的SAP患者预后的重要指标,年龄做为独立因素,与死亡率无关;入院1周内为死亡高峰期;多器官功能衰竭是SAP患者的主要死亡原因,但对于功能衰竭器官数多的患者不能丧失治疗信心。

【Abstract】 Objective: To observe the effect of the non-surgical treatment on the patients with SAP. Methods: The patients with SAP treated by non-surgical treatment in intensive care unit were retrospectively studied, and divided into the improved group and the dead group. Results: The APACHEⅡand acute physiologic measurements of the dead group are higher than those of the improved group. There were no differences in age and previous health status between the dead group and the improved group. The mortality of SAP was 47.83% (11/23), within 7 days of hospitalization, death accounted for 54.55% (6/11). The mortality caused by multiple organ failure (MOF) accounted for 54.55% (6/11). Conclusions: APACHEⅡ can be used to evaluate the risk of hospital death of the patients with SAP treated by non-surgical therapy. There is no relationship between mortality and age when it acts as an independent factor. Within 7 days of hospitalization is the critical period of death. MOF is the main cause for death. But we should not lose our confidence in treating the patients with MOF.

【关键词】 胰腺炎APACHEⅡ评分死亡死亡率
【Key words】 pancreatitisAPACHEⅡ gradedeathmortality
  • 【文献出处】 中国现代医学杂志 ,China Journal of Modern Medicine , 编辑部邮箱 ,2004年12期
  • 【分类号】R576
  • 【下载频次】48
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