【作者】 张瑜红；

【导师】 唐国都；

【作者基本信息】 广西医科大学 ， 消化内科， 2007， 硕士

【摘要】 目的研究重症急性胰腺炎(Severe Acute Pancreatitis,SAP)的临床特征及治疗措施。方法回顾性分析我院1996～2006年134例SAP的临床资料,包括患者年龄,性别,病因,住院时间,临床症状,并发症,治疗措施和疗效。分析重症急性胰腺炎中的特殊类型—暴发性急性胰腺炎(Fulminant AcutePancreatitis,FAP)的临床特征,探讨治疗措施。结果SAP发生的年龄20～85岁,其中30～60岁93例,占69.4%,平均年龄45.12±15.76岁,平均住院日23±22天;主要病因为胆道系统疾病,占32%,不明原因的SAP发生率高(25%);胸,腹水的发生率分别为44.0%、69.4%;本组SAP患者死亡率为14.2%;患者血清淀粉酶升高与否与病死率无关;FAP占本组SAP的20.9%;FAP组患者的并发症发生率和死亡率较SAP组患者明显升高;低氧血症与急性肾功能衰竭的发生率在FAP患者中较其他脏器衰竭显著升高。结论SAP多发生于30～60岁;胸,腹水的发生率在重症急性胰腺炎患者中高,胸水与并发症发生率及病死率无关;腹水与并发症发生率相关,与病死率无关;血淀粉酶升高与否与预后无关;SAP个体化治疗可取得良好效果;FAP是SAP的特殊类型,早期出现器官衰竭,死亡率高,临床上应予高度重视,尤其是低氧血症及急性肾功衰竭早期发生率高,应予早期识别,不失时机的救治FAP。更多还原

【Abstract】 Objective To investigate a consecutive series of patients with severe acute pancreatitis(SAP),to identify clinical characteristics and therapeutic effects.Methods Clinical data of 134 cases of SAP admitted to the first affiliated hospital of Guangxi Medical University from 1996 to 2006 were retrospectively reviewed.The data included the patients’age,gender,etiology,length of hospitalization,clinical symptom,complication,procedure of treatment,curative result and analyzed a special type of fulminant acute pancreatitis(FAP).Results The mean age of the patients was 45.12±15.76 years;the mean length of hospitalization was 23±22 days;the main etiological factors are biliary system disease(32%),the incidence of unknown origin was high(25%).The incidence of ascites and pleural effusion were very high in SAP patients.The mortality rate was 14.2%;the incidence of complication and mortality of FAP were higher than SAP.Conclusions Patients of SAP commonly occurred in 30～60 years.The incidence of unknown origin was high(25%).The level of serum amylase was irrelevant with the severity of SAP.The incidence of ascites and pleural effusion were very high in SAP patients;and the incidence of complication were significant higher in patients with ascites.In the earlier stage of SAP,the treatment should be observed carefully and combined therapy of internal medicine as soon as the indications of operation were found.FAP is a special type of SAP,with its high mortality,especially the high incidence of hypoxemia and acute renal failure,the effected therapeutic method should be attached great importance to the patient.更多还原