重症胰腺炎合并急性肾功能衰竭相关因素分析  

Analysis of correlative factors of acute renal failure complicating severe actue pancreatitis

作　　者：宋信英[1] 高素琴[1] 李若刚[1] 

机构地区：[1]河南省安阳钢铁集团公司职工总医院普外科,安阳455004

出　　处：《河南外科学杂志》2008年第1期8-9,共2页Henan Journal of Surgery

摘　　要：目的分析重症急性胰腺炎(SAP)合并急性肾功能衰竭(ARF)的临床特点及防治措施。方法回顾分析我院2000年1月至2006年12月收治SAP合并ARF的46例病人的临床资料,并用直线回归方法,对影响SAP合并ARF病死率的相关因素进行分析。结果病人的年龄、全身炎症反应综合征(SIRS)持续时间、病情严重程度(APACHEⅡ评分),急性呼吸窘迫综合征(ARDS)、多器官功能障碍综合征(MODS)、腹腔间室综合征(ACS)、感染及局部并发症等因素对预后有显著的影响。46例中死亡28例(60.9%),同时合并ARDS和MODS是病死率增加的重要原因。结论早期液体复苏、控制病情发展、积极有效的引流及早期重要脏器功能的支持是预防SAP并发ARF,改善预后的重要手段。Objective To analyse the clinical characteristics of acute renal failure （ARF） complicating severe actue pancreatitis （SAP）, and study the methods of preveution and therapy. Methods Forty - six patients with SAP who were in hospital between Jan. 2000 and Dec. 2006 complicated with ARF were retrospectively analyzed to conclude the mortality from ARF complicating SAP, then analyze the impact factors of them respectively linear regression methods. Results The distinct impact factors of it were the patients ＇age, the duration of SIRS, severity grade （ APACHE Ⅱ score ）, ARDS , MODS , ACS , infection and local complications and so on. 28 of 46 patients with ARF were dead and the mortality was 60.9%. Complicating ARDS and MODS simultaneously was the important reason of increasing mortality. Conclusion ARF is the severe complication of SAP, early liquid resuscitation,function protection of vital organs and positive eduction are the important measures to prevent SAP from complicating ARF and improve the prognosis.

关 键 词：胰腺炎 肾功能衰竭 多器官功能障碍综合征 

分 类 号：R692.5[医药卫生—泌尿科学] R395.6[医药卫生—外科学]