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重症急性胰腺炎临床特征和预后危险因素分析
Analysis of clinical characteristics and prognostic factors in severe acute pancre-atitis
【摘要】 目的分析重症急性胰腺炎(SAP)的临床特征,探讨影响病死率的高危险因素。方法回顾性分析2003年至2004年94例SAP的临床资料,包括患者年龄、性别、病因、住院时间、入院后48 h APACHE Ⅱ评分、局部及系统器官并发症。结果患者平均年龄52岁,最常见病因为胆源性,平均住院时间70 d, APACHEⅡ评分平均7.7分。57.4%并发坏死,26.6%并发坏死感染,61.7%并发器官、系统衰竭。其中,22 例死亡,病死率23.4%。死亡组中呼吸衰竭最常见,90.9%并发多器官、系统衰竭。Logistic回归分析显示呼吸、心血管系统和肾脏衰竭是与SAP死亡相关的独立高危险因素。结论 SAP死亡病例的特点是高年龄、入院时高APACHEⅡ评分和进行性器官、系统衰竭;多脏器衰竭是SAP死亡的主要原因;肺脏、心血管系统和肾脏衰竭是影响SAP预后的独立高危险因素。
【Abstract】 Objective To investigate a consecutive series of patients with SAP, identify clinical characteristics and explore the prognostic dangerous factors influencing mortality. Methods Clinical data of 94 SAP cases admitted to our hospital from 2003 to 2004 were retrospectively reviewed. Collected data included the patients’ age, gender, etiology, length of hospitalization, APACHE Ⅱ score at admission, local complications and organ / systemic complications. Results The mean age of the patients was 52; the commonest etiology cholelithiasis; the mean length of hospitalization 70 days; the mean score of APACHE Ⅱ 7.7; 57.4% petient developed necrosis; 26.6% developed necrotic infection; 61.7% developed organ / systemic failure. A total of 23.4% of the SAP died. In the deceased SAP, 90.9% developed multiple organ / systemic failures and respiratory failure was the most common organ dysfunction. By multivariate logistic regression analysis, independent prognostic factors for mortality were respiratory failure, cardiovascular failure and renal failure. Conclusion SAP is characterized by advanced age, high APACHE Ⅱ score, prooressive organ failure and mainly dies of multiple organ / systemic failures. In patients with SAP, failures of lung, cardiovascular system and renal function predict fatal outcome.
- 【文献出处】 肝胆胰外科杂志 ,Journal of Hepatopancreatobiliary Surgery , 编辑部邮箱 ,2006年02期
- 【分类号】R657.51
- 【被引频次】12
- 【下载频次】157