ICU术后患者血清淀粉酶升高的临床意义分析  

Clinical significance of serum amylase in post-operative patients in the ICU

作　　者：王吉文[1] 丘宇茹[1] 陈亮[1] 黄丹 常建星[1] 

机构地区：[1]中山大学孙逸仙纪念医院重症医学科,广州1510120 [2]深圳市龙岗区坪地人民医院心内科,广东深圳2518117

出　　处：《岭南现代临床外科》2016年第6期674-677,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省自然科学基金(10151008901000135);广东科技计划项目(2015A030302015)

摘　　要：目的了解ICU术后患者的血淀粉酶的流行病学特征和临床意义。方法回顾性分析符合入选标准的395例ICU术后患者,观察患者的基础病、手术部位、血和尿淀粉、血脂肪酶、胰腺影像变化,比较血淀粉酶升高患者的变化。结果 ICU术后43.3%患者血淀粉酶升高,1-3天开始升高,2-3天达高峰,多数升高1-2倍,持续1-3天,伴尿淀粉酶、血脂肪酶、影像改变和诊断胰腺炎分别为5.3%、7.6%、1.8%和1.8%,糖尿病患者升高率显著性降低（P〈0.05）,上腹部、颅脑、颈部手术发生率较高（P〈0.05）。结论 43.3%的ICU术后患者血淀粉酶3天内升高,以上腹部手术、颅脑和颈部发生率最高,伴糖尿病的发生率降低,但很少伴尿淀粉酶、血脂肪酶升高,极少诊断为急性胰腺炎。Objective To investigate the epidemiological characteristics and clinical significanceof serum amylase in postoperative patients with ICU. Methods A retrospective analysis of 395 cases ofeligible postoperative patients in ICU, we observed underlying disease, operative site, blood and urineamylase, blood lipase and imaging changes, and compared the change of blood amylase in patients withincreased amylase. Results serum amylase was elevated in 43.3% postoperative patients in ICU, beganby 1-3 days, peaked by 2-3 days, increased 1-2 times, kept 1-3 days. The percentage was respectively5.3%, 7.6%, 1.8% and 1.8% with urine amylase, lipase, imaging changes and diagnosis of pancreatitis. Theincidence rate was significantly lower in patients with elevated serum amylase with diabetes mellitus（P〈0.05）, and was high in upper abdomen, head and neck surgery（P〈0.05）. Conclusion The serum amylasewas elevated during 3 days in 43.3% postoperative patients in ICU. The incidence rate was the highest inupper abdominal, head and neck surgery. The incidence rate was reduced in the patient with diabetesmellitus. But the urine amylase and lipase rarely increased, the patient was very few with diagnosis of acutepancreatitis.

关 键 词：重症医学科 术后监测 血淀粉酶 

分 类 号：R604[医药卫生—外科学]