【摘要】 目的 :应用 APACHE 连续评分判断重症胰腺炎的严重性、预后和并发症 ,决定重症胰腺炎手术和再次手术时机。方法 :1991年 1月至 1998年 1月治疗重症胰腺炎 2 8例。急诊手术 2 3例 ,其中单次手术13例 ,多次手术 10例 ,非手术 5例。采用 APACHE 连续评分 ,间隔 2 4～ 48小时评分一次。死亡组与非死亡组连续评分比较 ,手术组与非手术组连续评分比较 ,单次手术组与多次手术组连续评分比较。结果 :连续评分逐日上升或居高不下是预后恶劣的重要信号 ,连续评分陡升说明发生并发症。结论 :连续 APACHE 评分对于判断重症胰腺炎的严重性和预后优于单次评分。单次评分不能预测并发症的发生 ,而连续评分可从其趋势上预知是否有重大并发症发生 ,并可据此决定手术适应证和再次手术适应证。更多还原

【Abstract】 Objective: To investigate the dynamic APACHEⅡ scoring used for assessing the severity, prognosis and morbidity of patients with SAP and for decision of operative intervention. Methods: From 1991 to 1998,28 cases with SAP were admitted in our department, operations were performed in 23 cases, Multiple operations were done in 10 cases and single operation in 13cases. The remains of patients were treated by non operation. APACHEⅡ scoring were obtained during admission and seqentially then at interval of 24～48hrs. A comparision of the APACHEⅡ scoring between survivals and nonsurvivals, patients with operative interference and conservative therapy, patients with unioperation and multioperation were undertaken. Results: Patients whose dynamic APACHEⅡ scoring elevated steadily or abruptly revealed a poor prognosis or severe complications. Conclusions: Our finding of the dynamic scoring among patients with SAP shows that seqentially evaluating APACHEⅡ scoring demonstrates a better predication of prognosis and survival for patients with SAP and the indicator of surgical intervention.更多还原