中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
8期
846-849
,共4页
多器官功能障碍综合征%胰腺损害%淀粉酶%脂肪酶%乳酸清除率%膀胱内压%急性生理功能和慢性健康状况评分系统Ⅱ评分%休克
多器官功能障礙綜閤徵%胰腺損害%澱粉酶%脂肪酶%乳痠清除率%膀胱內壓%急性生理功能和慢性健康狀況評分繫統Ⅱ評分%休剋
다기관공능장애종합정%이선손해%정분매%지방매%유산청제솔%방광내압%급성생리공능화만성건강상황평분계통Ⅱ평분%휴극
Multiple organ dysfunction syndrome%Pancreatic injury%Amylase%Lipase%Clearance rate of lactic acid%Bladder pressure%APACHE Ⅱ score%Shock
目的 探讨多器官功能障碍综合征患者出现胰腺损害时的病情特点.方法 前瞻性研究2011年1月至2012年12月间入住福建省立医院内科ICU的MODS患者69例根据入院时是否合并胰腺损害将其分为胰腺损害组(A组)和单纯MODS组(B组),比较两组的急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、6h乳酸清除率、休克的发生率、24 h及48 h补液量、膀胱内压、28 d累计病死率.结果 A组患者APACHEⅡ评分明显高于B组(P＜0.01)；其6h乳酸清除率降低,休克的发生率明显增加,24 h、48 h所需补液量也大于B组(P＜0.05)；A组膀胱内压、肠鸣音减弱的发生率、病死率和B组比较均有升高,但差异均无统计学意义(P＞0.05).结论 MODS合并胰腺损害时,其病情往往较重,休克的发生率高,液体反应性较单纯MODS患者差.
目的 探討多器官功能障礙綜閤徵患者齣現胰腺損害時的病情特點.方法 前瞻性研究2011年1月至2012年12月間入住福建省立醫院內科ICU的MODS患者69例根據入院時是否閤併胰腺損害將其分為胰腺損害組(A組)和單純MODS組(B組),比較兩組的急性生理功能和慢性健康狀況評分繫統Ⅱ(APACHEⅡ)評分、6h乳痠清除率、休剋的髮生率、24 h及48 h補液量、膀胱內壓、28 d纍計病死率.結果 A組患者APACHEⅡ評分明顯高于B組(P＜0.01)；其6h乳痠清除率降低,休剋的髮生率明顯增加,24 h、48 h所需補液量也大于B組(P＜0.05)；A組膀胱內壓、腸鳴音減弱的髮生率、病死率和B組比較均有升高,但差異均無統計學意義(P＞0.05).結論 MODS閤併胰腺損害時,其病情往往較重,休剋的髮生率高,液體反應性較單純MODS患者差.
목적 탐토다기관공능장애종합정환자출현이선손해시적병정특점.방법 전첨성연구2011년1월지2012년12월간입주복건성립의원내과ICU적MODS환자69례근거입원시시부합병이선손해장기분위이선손해조(A조)화단순MODS조(B조),비교량조적급성생리공능화만성건강상황평분계통Ⅱ(APACHEⅡ)평분、6h유산청제솔、휴극적발생솔、24 h급48 h보액량、방광내압、28 d루계병사솔.결과 A조환자APACHEⅡ평분명현고우B조(P＜0.01)；기6h유산청제솔강저,휴극적발생솔명현증가,24 h、48 h소수보액량야대우B조(P＜0.05)；A조방광내압、장명음감약적발생솔、병사솔화B조비교균유승고,단차이균무통계학의의(P＞0.05).결론 MODS합병이선손해시,기병정왕왕교중,휴극적발생솔고,액체반응성교단순MODS환자차.
Objective To explore the clinical characteristics of multiple organs dysfunction syndrome (MODS) complicated with injury of pancreas.Methods A prospective study was carried out.From January 2011 to December 2012,a total of 69 patients with MODS in Department of Medical Intensie Care Unit,Fujian Provincial Hospital,Fujian Medical University were divided into 2 groups at admission.Patients of group A were suffered from MODS complicated with pancreas injury while patients of group B had MODS without complicatios.They were compared and evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,6-hour clearance rate of lactic acid,incidence of shock,fluid resuscitation in the first 24 and 48 hours,bladder pressure and 28-day accumulative mortality.Results APACHE Ⅱ score in group A was significantly higher than that in group B (P ＜ 0.01).Compared with group B,the 6-hour clearance rate of lactic acid was lower,the incidence of shock increased obviously,and larger volume of fluid resuscitation was needed in the first 24 and 48 hours in the group A (P ＜ 0.05).Bladder pressure,incidence of feeble bowel sounds and the mortality in the group A were higher than those in group B,but the difference had no statistical significance (P＞0.05).Conclusions MODS complicated with pancreas injury is more severe than MODS without complications thereby resulting in higher incidence of shock and the poorer response to fluid resuscitation.
