中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2014年
3期
145-148
,共4页
胰腺炎%多器官功能障碍%预后
胰腺炎%多器官功能障礙%預後
이선염%다기관공능장애%예후
Pancreatitis%Multiple organ dysfunction%Prognosis
目的 探讨急性胰腺炎病程中出现的脏器功能衰竭的规律.方法 回顾性分析瑞金医院2001年1月至2008年12月外科收治的783例重症急性胰腺炎(SAP)患者资料,依据2012版急性胰腺炎分类标准,将原诊断为SAP的患者细分为中度急性胰腺炎(MSAP)和重度急性胰腺炎(SAP).器官功能衰竭的评判建立在SOFA评分标准的基础上.结果 783例患者中MSAP患者573例,SAP患者210例.病因以胆源性为主,占47.9%.治愈698例,病死85例,病死率为10.9%.783例患者中共273例(34.9%)出现器官功能衰竭,其中出现1、2、3个和4个及以上器官功能衰竭的患者分别为109、81、60和23例,病死例数分别为2、30、30和23例,4个及以上器官功能衰竭患者的病死率为100%.出现单个器官功能衰竭的109例中,MSAP 48例,SAP 61例,98.2%被成功治愈,仅2例病死.出现多器官功能衰竭的164例中,MSAP 15例,SAP 149例,50.6%的患者病死.发生呼吸系统、心血管系统、神经系统、肾功能、血液系统、肝功能衰竭患者分别为206例次(26.3%)、103例次(13.2%)、92例次(11.7%)、80例次(10.2%)、41例次(5.2%)、27例次(3.4%),病死率分别为38.8%(126/206)、49.5% (51/103)、37.0% (34/92)、63.8% (51/80)、53.7% (22/41)、44.4%(12/27).呼吸功能衰竭发生率最高,肾功能衰竭病死率最高.结论 在AP病程中单个器官功能衰竭发生率最高,但病死率很低,4个及以上器官功能衰竭发生率较低,但病死率高达100%;呼吸系统和心血管系统功能衰竭的发生率最高,肾功能和血液系统功能衰竭的预后最差.
目的 探討急性胰腺炎病程中齣現的髒器功能衰竭的規律.方法 迴顧性分析瑞金醫院2001年1月至2008年12月外科收治的783例重癥急性胰腺炎(SAP)患者資料,依據2012版急性胰腺炎分類標準,將原診斷為SAP的患者細分為中度急性胰腺炎(MSAP)和重度急性胰腺炎(SAP).器官功能衰竭的評判建立在SOFA評分標準的基礎上.結果 783例患者中MSAP患者573例,SAP患者210例.病因以膽源性為主,佔47.9%.治愈698例,病死85例,病死率為10.9%.783例患者中共273例(34.9%)齣現器官功能衰竭,其中齣現1、2、3箇和4箇及以上器官功能衰竭的患者分彆為109、81、60和23例,病死例數分彆為2、30、30和23例,4箇及以上器官功能衰竭患者的病死率為100%.齣現單箇器官功能衰竭的109例中,MSAP 48例,SAP 61例,98.2%被成功治愈,僅2例病死.齣現多器官功能衰竭的164例中,MSAP 15例,SAP 149例,50.6%的患者病死.髮生呼吸繫統、心血管繫統、神經繫統、腎功能、血液繫統、肝功能衰竭患者分彆為206例次(26.3%)、103例次(13.2%)、92例次(11.7%)、80例次(10.2%)、41例次(5.2%)、27例次(3.4%),病死率分彆為38.8%(126/206)、49.5% (51/103)、37.0% (34/92)、63.8% (51/80)、53.7% (22/41)、44.4%(12/27).呼吸功能衰竭髮生率最高,腎功能衰竭病死率最高.結論 在AP病程中單箇器官功能衰竭髮生率最高,但病死率很低,4箇及以上器官功能衰竭髮生率較低,但病死率高達100%;呼吸繫統和心血管繫統功能衰竭的髮生率最高,腎功能和血液繫統功能衰竭的預後最差.
목적 탐토급성이선염병정중출현적장기공능쇠갈적규률.방법 회고성분석서금의원2001년1월지2008년12월외과수치적783례중증급성이선염(SAP)환자자료,의거2012판급성이선염분류표준,장원진단위SAP적환자세분위중도급성이선염(MSAP)화중도급성이선염(SAP).기관공능쇠갈적평판건립재SOFA평분표준적기출상.결과 783례환자중MSAP환자573례,SAP환자210례.병인이담원성위주,점47.9%.치유698례,병사85례,병사솔위10.9%.783례환자중공273례(34.9%)출현기관공능쇠갈,기중출현1、2、3개화4개급이상기관공능쇠갈적환자분별위109、81、60화23례,병사례수분별위2、30、30화23례,4개급이상기관공능쇠갈환자적병사솔위100%.출현단개기관공능쇠갈적109례중,MSAP 48례,SAP 61례,98.2%피성공치유,부2례병사.출현다기관공능쇠갈적164례중,MSAP 15례,SAP 149례,50.6%적환자병사.발생호흡계통、심혈관계통、신경계통、신공능、혈액계통、간공능쇠갈환자분별위206례차(26.3%)、103례차(13.2%)、92례차(11.7%)、80례차(10.2%)、41례차(5.2%)、27례차(3.4%),병사솔분별위38.8%(126/206)、49.5% (51/103)、37.0% (34/92)、63.8% (51/80)、53.7% (22/41)、44.4%(12/27).호흡공능쇠갈발생솔최고,신공능쇠갈병사솔최고.결론 재AP병정중단개기관공능쇠갈발생솔최고,단병사솔흔저,4개급이상기관공능쇠갈발생솔교저,단병사솔고체100%;호흡계통화심혈관계통공능쇠갈적발생솔최고,신공능화혈액계통공능쇠갈적예후최차.
Objective To investigate the pattern of organ dysfunction in acute pancreatitis.Methods Seven hundred and eighty-three SAP patients who were treated in Department of Surgery,Ruijin Hospital from January 2001 to December 2008 were retrospectively analyzed.According to 2012 acute pancreatitis classification,these SAP patients were further divided into MSAP and SAP.Diagnosis of organ dysfunction was based on SOFA scores.Results Among the 783 patients,there were 573 MSAP patients and 210 SAP patients.The main etiology was of biliary origin (47.9%).Six hundred and ninety-eight patients survived,and 85 patients died with the mortality rate of 10.9%.Among the 783 patients,organ dysfunction occurred in 273(34.9%) patients,and the number of patients with 1,2,3,4 or more organs dysfunction was 109,81,60 and 23,and the mortality was 1.8% (2 patients),37.0% (30 patients),50.0% (30 patients),100%.Among the 109 patients with single organ dysfunction,there were 48 MSAP and 61 SAP patients,and 98.2% was cured,only 2 patients died.Among the 164 patients with multiple organ dysfunction,there were 15 MSAP and 149 SAP patients,and 50.6% died.Respiratory,cardiovascular,nervous,renal,hematologic and liver dysfunction occurred in 206 (26.3%),103 (13.2%),92 (11.7%),80 (10.2%),41 (5.2%),27 (3.4%); and the mortality rates were 38.8% (126/206),49.5% (51/103),37.0% (34/92),63.8% (51/80),53.7% (22/4),44.4% (12/27).Respiratory dysfunction had the highest incidence,and renal failure was associated with the highest mortality.Conclusions In the course of acute pancreatitis,single organ dysfunction has the highest incidence but the mortality is low.Four or more organs dysfunction has the lowest incidence,but the mortality is 100%.Respiratory and cardiovascular dysfunction has the highest incidence,and renal,hematologic dysfunction is associated with poorest prognosis.