强化胰岛素治疗严格控制血糖对重症急性胰腺炎的影响

目的：探讨强化胰岛素治疗严格控制血糖对重症急性胰腺炎患者的影响。方法：将42例重症急性胰腺炎患者按入院先后分为两组：A组和B组，每组21例。两组均采用微量注射泵输入胰岛素。A组控制血糖在10．0～11-1mmoL／L，B组控制血糖在4．4～6．1mmoL／L。观察两组使用呼吸机时间、住院时间、APACHEⅡ评分及并发症等情况。结果：B组使用呼吸机时间、住院时间均明显缩短（P均〈0．05）。B组APACHEⅡ评分及胰腺感染发生率均显著降低（P均〈0．05）。结论：强化胰岛素治疗严格控制血糖能够改善重症急性胰腺炎患者预后。     

重症急性胰腺炎综合治疗83例疗效观察

重症急性胰腺炎 (severe acute pancreatitis SAP)的治疗方法有手术疗法和非手术疗法两种选择 ,手术时机和术式选择仍有较多争议 [1 ] 。我院 1988- 0 1～ 2 0 0 2 - 12共收治 SAP83例 ,对不同时期手术或非手术治疗回顾性分析如下。1　对象和方法1.1　对象　本组男 4 5例 ,女 38例 ;年龄 7～ 73岁 ,平均 4 0 .3岁。因暴饮暴食、酗酒起病 34例 ,有胆道病史者 2 3例 ,原因不明2 6例。 83例均有腹痛、恶心、呕吐、腹部压痛。有酸胀 4 6例。均进行了血、尿淀粉酶及 CT检查 ,按中华医学会胰腺外科学组的临床诊断及分级标准均符合 SAP的诊断…     

重症急性胰腺炎早期治疗再认识

目的：探讨重症急性胰腺炎(SAP)的合理有效的个体化治疗方案。方法：对168例SAP临床资料进行回顾分析。结果：以非手术治疗为主的综合治疗组并发症发生率为34．5％，病死率为23．1％，而手术组并发症发生率为58．3％，病死率为32．1％，其明显高于非手术组。结论：SAP早期宜行非手术治疗，一旦有手术指征，应及时手术治疗。     

重症急性胰腺炎综合治疗的疗效分析

我院 1991年 3月～ 2 0 0 0年 8月收治重症急性胰腺炎 (ＳＡＰ) 112例 ,采用以非手术治疗为主的综合治疗获得较好疗效 ,初步总结其治疗经验 ,以求进一步探寻更为合理的治疗策略。一、临床资料本组 112例 ,男性 5 4例 ,女性 5 8例 ,年龄 2 1～ 79岁 ,平均 5 5 7岁。根据 1996年全国急性胰腺炎的临床诊断及分级标准 (第二次方案 ) [1 ] ,确诊为ＳＡＰ。患者入院时已有 1个或 1个以上器官功能不全 43例 ,占 38 4% ,其中成人呼吸窘迫综合征 (ＡＲＤＳ) 36例 ,肾功能衰竭 5例 ,胰性脑病 2例。保守治疗措施包括 :禁食、胃肠减压、补充血容量及纠…     

胰岛素强化治疗在重症急性胰腺炎治疗中的作用

近年来,采用胰岛素强化治疗控制应激性高血糖在危重症患者的治疗中受到广泛关注,严格控制血糖水平能改善患者机体免疫功能,抑制炎症介质释放,降低感染和多器官功能障碍的发生。重症急性胰腺炎(SAP)是常见的危重症,常合并严重的代谢紊乱和感染等并发症。大量研究表明,胰岛素强化治疗可通过改善SAP患者免疫功能,降低肠黏膜通透性,抑制炎症因子释放等机制缓解患者病情,缩短患者住院时间和减少并发症的发生,改善临床预后。本文就胰岛素强化治疗在SAP患者中的作用机制作一综述。     

高脂血症性重症急性胰腺炎临床特征分析

目的 探讨重症急性胰腺炎(SAP)伴有高TG患者的临床特点.方法 收集发病后72 h内入院的SAP患者82例,按入院时血清TG水平分为高TG组(≥1.7 mmol/L)26例,正常TG组(<1.7mmol/L)56例.结果 高TG者占同期SAP患者的31.71%(26/82).高TG组患者入院时的APACHE-Ⅱ评分高于正常TG组(14.62±7.58比10.68±5.21,P<0.01).高TG组在发病72 h内的心、肺和肾脏功能不全的发生率高于正常TG组(34.62%、34.62%、19.23%比5.36%、3.57%、1.79%,P均<0.01),假性囊肿的发生率亦增高(42.31%比7.14%,P<0.01).高TG组无急症或早期手术治疗病例,正常TG组为13例(23.21%);高TG组和正常TG组分别有2例和4例中转手术.结论 高TG的SAP患者早期脏器功能不全发生率和局部并发症高,治疗应以非手术为主.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

中西医结合治疗重症急性胰腺炎96例临床疗效观察

目的：探讨中西医结合治疗重症急性胰腺炎的方法。方法：对96例重症急性胰腺炎治疗进行分析，对照组44例采用基本支持治疗及手术；治疗组52例采用基本支持治疗及大承气汤。结果：治疗组较对照组并发症减少，死亡率低；治疗组较对照组肠功能恢复快，腹水吸收快，住院日缩短。结论：中西医结合治疗重症急性胰腺炎能降低并发症及死亡率，并使治愈时间缩短。     

大黄对重症急性胰腺炎的治疗价值观察

目的：探讨大黄对重症急性胰腺炎（SAP）的治疗价值。方法：我们将42例SAP患者随机分为大黄治疗组（21例）和对照组（21例）。大黄治疗组胃管注入大黄粉200mg/kg,每日1－2次,其余治疗均与对照组相同。结果：大黄治疗组血浆内毒素含量显著低于对照组,症状缓解迅速。结论：大黄用于急性胰腺炎的治疗有重要价值。     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.     

高脂血症性重症急性胰腺炎临床特征分析

Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.