急性胰腺炎中全身炎性反应综合征与多器官功能障碍综合征的临床分析  

Clinical study of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in acute pancreatitis

作　　者：姚峰[1] 邹力[1] 程宝琴[1] 王晓军[2] 

机构地区：[1]湖北医科大学附属第一医院普外科,武汉430060 [2]湖北医科大学附属第一医院,武汉430060

出　　处：《上海医学》1999年第12期714-716,共3页Shanghai Medical Journal

摘　　要：目的　分析急性胰腺炎患者中全身炎症反应综合征（ＳＩＲＳ） 和多器官功能障碍综合征（ＭＯＤＳ） 的关系，探讨从ＳＩＲＳ到ＭＯＤＳ的发展变化过程及治疗策略。方法　将８３ 例急性胰腺炎患者（轻型５３ 例、重型３０ 例）分为非ＳＩＲＳ组及ＳＩＲＳ组，后者又分为非感染性ＳＩＲＳ、全身性感染及感染性休克，统计各种ＳＩＲＳ发生率和病死率及ＭＯＤＳ患病率和病死率，率的比较采用卡方检验。结果　ＳＩＲＳ组的ＭＯＤＳ患病率高于非ＳＩＲＳ组（Ｐ＜ ０ ．０５），且随ＳＩＲＳ程度的加重，病死率和ＭＯＤＳ患病率依次升高（ Ｐ＜ ０ ．０５ 、Ｐ＜ ０ ．０１），重型病例的ＳＩＲＳ发生率和ＭＯＤＳ患病率高于轻型（ Ｐ＜ ０．０５、Ｐ＜０ ．０１）。结论　急性胰腺炎患者中ＳＩＲＳ程度及有无感染与ＭＯＤＳ的发生及预后均有密切关系。Objective To analyze the relationship between systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in acute pancreatitis, and to explore the therapeutic strategies during progression from SIRS to MODS. Methods 83 acute pancreatitis patients (simple 53, severe 30) were divided into non SIRS and SIRS groups. The SIRS group was again categorized into non infectious SIRS, sepsis and septic shock. The frequency and mortality rates of SIRS, the rates of morbidity and mortality of MODS were all analyzed. All data were processed statistically (chi square test).Results The morbidity of MODS in SIRS group was higher than that non in SIRS group ( P < 0.005). The mortality and the morbidity rates of MODS corresponded to the degree of SIRS. The morbidity of SIRS and MODS of severe patients was also higher than those of the simple ones ( P<0.05,P< 0.01 ). Conclusion The degree of SIRS and infection were closely related to the presence of MODS and prognosis of patients with acute pancreatitis. The prognosis of severe pancreatitis may be partly due to the higher morbidity rates of SIRS and MODS.(Shanghai Med J, 1999,22∶714 716)

关 键 词：胰腺炎 全身炎症反应 综合征 多器官衰竭 

分 类 号：R576.06[医药卫生—消化系统] R59[医药卫生—内科学]