中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
6期
404-406
,共3页
何满西%张肇达%刘续宝%田伯乐%胡伟明%李耿%姚有贵%蒲道深%陆慧敏%李建水
何滿西%張肇達%劉續寶%田伯樂%鬍偉明%李耿%姚有貴%蒲道深%陸慧敏%李建水
하만서%장조체%류속보%전백악%호위명%리경%요유귀%포도심%륙혜민%리건수
胰腺炎%死亡%原因
胰腺炎%死亡%原因
이선염%사망%원인
Pancreatitis%Death%Cause
目的 分析重症急性胰腺炎(severe acute pancreatitis,SAP)的主要病死原因,提高诊治水平.方法 回顾性分析1997年6月至2006年5月收治的1162例SAP病人,其中病死144例(12.39%),放弃治疗82例(7.06%),痊愈936例(80.55%),对病死组与痊愈组的临床资料进行统计学分析.结果 病死组APACHEⅡ评分和胰腺Balthazar CT评分高于存活组;病死组单一器官功能不全、多器官功能障碍综合征(MODS)的百分率与存活组比较有统计学差异;无明显诱因的SAP病死率明显高于有诱因者.结论 中西医结合非手术疗法是治疗SAP可供选择的方法,无明显诱因的SAP是当前治疗的难题,胰腺的病变程度轻重及全身情况好坏是影响SAP病死率的首要原因,早期诊断和治疗是降低其病死率的关键,维护重要器官功能的是其疗效的根本保障.
目的 分析重癥急性胰腺炎(severe acute pancreatitis,SAP)的主要病死原因,提高診治水平.方法 迴顧性分析1997年6月至2006年5月收治的1162例SAP病人,其中病死144例(12.39%),放棄治療82例(7.06%),痊愈936例(80.55%),對病死組與痊愈組的臨床資料進行統計學分析.結果 病死組APACHEⅡ評分和胰腺Balthazar CT評分高于存活組;病死組單一器官功能不全、多器官功能障礙綜閤徵(MODS)的百分率與存活組比較有統計學差異;無明顯誘因的SAP病死率明顯高于有誘因者.結論 中西醫結閤非手術療法是治療SAP可供選擇的方法,無明顯誘因的SAP是噹前治療的難題,胰腺的病變程度輕重及全身情況好壞是影響SAP病死率的首要原因,早期診斷和治療是降低其病死率的關鍵,維護重要器官功能的是其療效的根本保障.
목적 분석중증급성이선염(severe acute pancreatitis,SAP)적주요병사원인,제고진치수평.방법 회고성분석1997년6월지2006년5월수치적1162례SAP병인,기중병사144례(12.39%),방기치료82례(7.06%),전유936례(80.55%),대병사조여전유조적림상자료진행통계학분석.결과 병사조APACHEⅡ평분화이선Balthazar CT평분고우존활조;병사조단일기관공능불전、다기관공능장애종합정(MODS)적백분솔여존활조비교유통계학차이;무명현유인적SAP병사솔명현고우유유인자.결론 중서의결합비수술요법시치료SAP가공선택적방법,무명현유인적SAP시당전치료적난제,이선적병변정도경중급전신정황호배시영향SAP병사솔적수요원인,조기진단화치료시강저기병사솔적관건,유호중요기관공능적시기료효적근본보장.
Objective To explore the main causes for death due to severe acute pancreatitis (SAP) to improve the level of diagnosis and treatment. Methods The clinical data of 1162 SAP cases treated in our hospital from June 1997 to May 2005 were retrospectively analyzed. Among which, 144patients (12. 39%) died, 82(7.06%)abandoned treatment and 936(80.55%)were cured. Results the APACHE Ⅱ scores and pancreas Balthazar CT scores of the death group were higher than that of the survival group. The percentage of single one organ dysfunction and multiple organ dysfunction syndrome (MODS) was significantly higher in the death group than in the survival group. The mortality rate of SAP without obvious inducing factors was significantly higher than that of SAP with inducing factors. Conclusion Integrated traditional and western non-surgical treatment is effective for SAP.The treatment for SAP without obvious inducing factors is a challenge. The mortality rate of SAP is primarily related to the pathological changes of pancreas and the patient's general condition. Early diagnosis and treatment is important to decrease mortality rate and maintaining the function of important organs is basic to ensure curative effect.
