重症急性胰腺炎早期预后相关因素分析  

An analysis of early prognosis-related factors for severe acute pancreatitis

作　　者：赵晓海 

机构地区：[1]浙江省乐清市第二人民医院外科,325608

出　　处：《实用医学杂志》2008年第9期1516-1518,共3页The Journal of Practical Medicine

摘　　要：目的:明确入院24h内哪些因素和重症急性胰腺炎(severe acute pancreatitis,SAP)死亡相关。方法:将1998年1月至2007年6月我院收治的56例SAP患者分为死亡组和存活组,回顾性分析入院24h内的临床和实验室资料。结果:两组间年龄、入院时心率、呼吸频率、24h尿量、24h内通便与否、血肌酐、血糖、白蛋白、血pH值、动脉血氧分压、碳酸氢根差异有显著性,而平均动脉压、血尿淀粉酶、白细胞、红细胞压积、血小板、血脂、肝功能、电解质、血尿素氮、性别及SAP的病因差异无显著性。结论:年龄、入院时心率、呼吸频率、24h尿量、24h内通便与否、血肌酐、血糖、白蛋白、血pH值、动脉血氧分压、碳酸氢根是SAP死亡的相关因素,对上述因素要加强监护,保持有效循环血量,并注意水电解质酸碱平衡及血糖的稳定,促进肠道动力恢复,防止肠道细菌和内毒素移位。Objective Severe acute pancreatitis （SAP） has multiple complications and a higher mortality rate. We try to figure out the factors associated with death from SAP within 24 hours of admission. Methods The patients with SAP who were. treated from January 1998 to June 2007 in our hospital were divided into death group and survival group and their clinical and laboratory data within 24 hours of admission were retrospectively analyzed. Results There were significant differences between the two groups in average age, heart rate and respiratory rate at admission, urine 24-hour volume after admission, defaecation or not within 24 hours of admission, ereatinine, blood sugar, albumin, arlerial PH, PaO2, and HCO3^-. But mean arlerial pressure, blood and urine amylase levels, WBC count, Hct, PLT count, blood lipid levels, liver function, electrolytes, BUN, sex, and etiology of the disease did not differ significantly. Conclusions Average age, heart rate and respiratory rate at admission, urine 24-hour volume after admission, defaecation or not within 24 hours of admission, creatinine, blood sugar, albumin, arterial pH, PaO2, and HCO3^- are the related factors for death from SAP. It is very important to strengthen monitoring the aforementioned factors, preserve effective circulating blood volume, maintain electrolyte and acid-base balance, stabilize blood sugar, restore intestinal movement, and prevent the translocation of intestinal bacteria and endotoxin.

关 键 词：胰腺炎 急性坏死性 预后 危险因素 

分 类 号：R657.51[医药卫生—外科学] R395.6[医药卫生—临床医学]