改善微循环和防止细胞钙超载在阻止急性胰腺炎重症化治疗中的作用  

Effect of improving microcirculation and preventing cell Ca^(2+) overload on halting progress of mild acute pancreatitis to severe acute pancreatitis

作　　者：蒲青凡[1] 严律南[2] 孙碎康[1] 张川蓉[1] 金凯[1] 戴华卫[1] 陈邦飞[1] 李荣祥[3] 

机构地区：[1]浙江省瑞安市人民医院外二科,325200 [2]华西医科大学附属第一医院普外科 [3]四川省攀枝花市第五人民医院肝胆科

出　　处：《临床外科杂志》2002年第1期17-19,共3页Journal of Clinical Surgery

摘　　要：目的　探讨改善胰腺缺血和防止钙超载在阻止急性胰腺炎重症化治疗中的作用。方法　报道 2 78例急性胰腺炎 (AP)的治疗及体会。第一阶段 (1990年 1月至 1994年 12月 )采取常规非手术治疗 ,第二阶段 (1995年 1月至 1999年 12月 )采取改善微循环和防止细胞钙超负荷的措施。结果　后阶段的治疗方案可明显降低轻型胰腺炎向重症胰腺炎的转化率 ,减少全身并发症发生率 ,降低死亡率 ,缩短治愈时间。结论　重点改善胰腺缺血和防止细胞钙超负荷的治疗有助于阻止AP由轻型向重症的发展 ,限制胰腺坏死 。Objective To evaluate the effect of improving microcirculation and preventing cell Ca 2+ overload in preventing the development of acute pancreatitis (AP).Methods 278 AP patients admitted from 1990 to 1994 and from 1995 to 1999 were retrospectively analyzed. Routine conservative managements were performed in the first stage,improving microcirculation and preventing cell Ca 2+ overload were performed in the second stage.Results During the first period,there were 124 patients with AP.The conversion of mild AP to severe AP developed in 28 of 120 patients with mild AP.18 of 32 patients with severe AP developed systemic complications,24 patients developed local complications,there were 9 deaths.During the second period,154 cases were treated ,the conversion of mild AP to severe AP presented in 16 of 149 patients with mild AP. 4 of 21 patients with severe AP presented systemic complications,19 patients presented local complications, 3 patients died.Conclusion Improving pancreatic microcirculation and preventing pancreatic cell Ca 2+ overload are helpful not only to prevent the conversion of mild pancreatitis to severe pancreatitis,but also to prevent progressive pancreatic necrosis, and improve the prognosis of acute pancreatitis.

关 键 词：胰腺炎 微循环 钙超负荷 预后 

分 类 号：R657.51[医药卫生—外科学]