重症胰腺炎患者死亡时间和原因分析  

The analysis of the death time and causes of severe acute pancreatitis

作　　者：罗世成[1] 章时彦[1] 胡瑞祥[1] 时德[2] 

机构地区：[1]云南省第一人民医院普外科,昆明650032 [2]重庆医科大学附属第一医院普外科,重庆400016

出　　处：《肝胆胰外科杂志》2001年第4期198-199,共2页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :探讨急性重症胰腺炎 (SAP)的临床死亡原因和死亡时间。方法 :回顾分析我院 1991～ 2 0 0 0年间收治的 10 2例SAP患者的病死率、死亡时间和死亡原因等情况。结果 :SAP患者的病死率为 2 6 .5 % (2 7/10 2 ) ,住院 7天内死亡比例为 6 6 .7% (18/ 2 7) ,7～ 14天死亡比例达 2 2 .2 % (6 / 2 7)。死亡的主要原因是成人呼吸窘迫综合征 (占 33.3 % ,9/ 2 7)和多器官功能衰竭 (占 44 .4% ,12 / 2 7)。结论 :SAP早期 (住院 7天内 )是死亡高峰期 ,早期循环障碍和肺功能损害的发展以及胰腺坏死合并感染均加重了多系统功能的损害 ,最终出现MOF ,这是SAP患者的主要死亡原因。早期阻断炎性介质的作用 ,改善循环障碍 ,及早识别和治疗低氧血症以及全身感染的预防和治疗是提高SAP预后的重要措施。Objective:To discuss the death time and causes of severe acute pancreatitis(SAP).Methods:102 patients with SAP from 1991～2000 were retrospectively studied.Results:In our hospital, the mortality rate of SAP was 26.5%. Within 7 days of hospitalization, death accounted for 66.7%(18/27); within 8 to 14 days accounted for 22.2%(6/27). The death of the patients was mainly caused by the adult respiratory distress syndrome(ARDS) and multiple organ failure(MOF).Conclusion:In the course of SAP, death within the first week after admission remains the highest. The deterioration of the early circulatory dysfunction and lung injury, and necrosis of pancreas with secondery infection aggravate multiple organ dysfunction, which lead to MOF. The important measures in the treatment of SAP include inhibiting the circulatory dysfunction and improving the hypooxemia in the early course of SAP, prevention and treatment of the infection.

关 键 词：胰腺炎 死亡原因 死亡 时间 病死率 

分 类 号：R657.51[医药卫生—外科学]