重症胰腺炎病死原因分析：附144例  

Death caused by severe acute pancreatitis：an anlaysis of 144 cases

作　　者：何满西[1] 张肇达[1] 刘续宝[1] 田伯乐[1] 胡伟明[1] 李耿[2] 姚有贵[2] 蒲道深 陆慧敏[1] 李建水[3] 

机构地区：[1]四川大学华西医院普外科,成都610041 [2]四川省雅安市人民医院肝胆外科,雅安625000 [3]川北医学院附属医院普外科,南充637000

出　　处：《中华肝胆外科杂志》2010年第6期404-406,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：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.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.

关 键 词：胰腺炎 死亡 原因 

分 类 号：R576[医药卫生—消化系统]