重症急性胰腺炎的治疗与预后临床分析

目的探讨重症急性胰腺炎（severe acute pancreatitis，SAP）的治疗方法与预后的关系。方法回顾性分析收治的164例SAP的临床特征、治疗方法、并发症、病死率等资料。结果非手术治疗54例；手术治疗110例，其中早期手术69例，延期手术41例。早期手术的并发症发生率和病死率分别为81．2％和30．4％，明显高于非手术及延期手术治疗患者。结论SAP治疗方法是影响疗效的重要因素，早期采用非手术为主的综合治疗能有效降低并发症发生率和病死率，但对有早期手术或延期手术指征的患者，应及时手术治疗。     

营养支持与重症急性胰腺炎预后的相关性

目的探讨营养支持对重症急性胰腺炎（SAP）预后的影响.方法：将32例SAP患者于入院后第1周内随机分为肠内营养（E）组8例、肠外营养（P）组12例、肠内营养加肠外营养（C）组12例,在常规治疗的同时,分别给予不同方式的营养支持.结果：C组并发症发生率明显低于E组、P组,外周血白蛋白及血糖水平优于E组、P组.结论：肠内营养加肠外营养不仅可以促进肠道功能的恢复和营养状况的维持,对减少SAP并发症和病死率具有积极作用.     

血糖变化在急性胰腺炎的临床意义

分析了３０４例急性胰腺炎（ＡＰ）的血糖变化。急性胰腺炎时５７．３％的患者血糖升高。死亡组的血糖平均值（１６．１３％ｍｍｏｌ／Ｌ）明显高于生存组（１０．２３％ｍｍｏｌ／Ｌ）,随着血糖的逐渐升高,患者的死亡率也随之升高。通过对血糖变化与代谢紊乱、胰性脑病的发生率等关系的分析,可发现在ＡＰ和重症胰腺炎（ＳＡＰ）时,及时合理地应用胰岛素调整血糖如同及时地清除胰腺坏死灶、抗感染、抑制胰腺分泌等治疗措施一样具有重要的作用,可明显地改变治疗效果。     

重症急性胰腺炎的治疗与预后临床分析

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)的治疗方法与预后的关系。方法回顾性分析收治的164例SAP的临床特征、治疗方法、并发症、病死率等资料。结果非手术治疗54例;手术治疗110例,其中早期手术69例,延期手术41例。早期手术的并发症发生率和病死率分别为81.2%和30.4%,明显高于非手术及延期手术治疗患者。结论SAP治疗方法是影响疗效的重要因素,早期采用非手术为主的综合治疗能有效降低并发症发生率和病死率,但对有早期手术或延期手术指征的患者,应及时手术治疗。     

早期急性重症胰腺炎预后因素分析

Objective Analysis of early risk predict markers within 24h after admission of prognosis in severe acute pancreatitis (SAP). Methods Medical records of 127 patients with sever acute pancreatitis admitted to our hospital within 72h after onset from February 2006 to July 2009 were retrospectively analyzed. These inpatients were grouped into survival group (102 cases) and death group (25 cases). The clinical and laboratory data within 24h after admission were compared between two groups. Results Compared with survival group, patients in death group had significantly difference in heart rate, respiratory, PaO2, pH value, serum calcium, serum kalium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱscores (P<0.05). Higher APCHE Ⅱ scores after admission was an independent early high risk predicator of death. Conclusions Death group was characterized as severe multiple organ dysfunction and severe internal disturbance. Heart rate, respiratory, PaO2, pH value, serum calcium, serum potassium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱ scores were early risk predict markers of death in patients with sever acute pancreatitis.     

早期急性重症胰腺炎预后因素分析

Objective Analysis of early risk predict markers within 24h after admission of prognosis in severe acute pancreatitis (SAP). Methods Medical records of 127 patients with sever acute pancreatitis admitted to our hospital within 72h after onset from February 2006 to July 2009 were retrospectively analyzed. These inpatients were grouped into survival group (102 cases) and death group (25 cases). The clinical and laboratory data within 24h after admission were compared between two groups. Results Compared with survival group, patients in death group had significantly difference in heart rate, respiratory, PaO2, pH value, serum calcium, serum kalium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱscores (P<0.05). Higher APCHE Ⅱ scores after admission was an independent early high risk predicator of death. Conclusions Death group was characterized as severe multiple organ dysfunction and severe internal disturbance. Heart rate, respiratory, PaO2, pH value, serum calcium, serum potassium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱ scores were early risk predict markers of death in patients with sever acute pancreatitis.     

急性胰腺炎患者血糖变化及其临床意义

目的：探讨急性胰腺炎患者血糖变化及其临床意义。方法：分析血糖增高的115例各型急性胰腺炎患者血糖升降的规律及其与预后的关系。结果：115例急性胰腺炎患者血糖均升高。其中轻型、重症I型和Ⅱ型患者血糖的中位数分别为8．7mmol/L、18．45mmol/L和27．22mmol／L，治疗后血糖恢复正常时间分别为3－17d、7－26d和24－46d,3组间差异有显著性意义（P＜0．001）。115例中66例应用胰岛素，其中85例轻型者中仅36例使用，而30例重型者则全部使用，且使用量大。结论：急性胰腺炎程度越重，血糖增高幅度及胰岛素用量越大，血糖恢复正常时间越长。     

急性胰腺炎病人入院时血、尿淀粉酶水平与预后的关系

虽近年国外对胰淀粉酶在诊断急性胰腺炎中的意义有质疑[1] ,但就目前临床工作而言 ,血、尿淀粉酶升高仍然是诊断急性胰腺炎最重要的实验室指标[2 ] 。本文回顾性分析了我院近 3年收治的急性胰腺炎病人的临床资料 ,旨在探讨急性胰腺炎病人入院时血、尿淀粉酶升高的程度与其预后的关系。资料与方法　　 1.病例连续选取我院 1997年 1月～ 2 0 0 0年 9月资料完整的急性胰腺炎病人 2 80例 ,其中男 12 4例 ,女 15 6例。年龄 <6 0岁 16 4例 ,≥ 6 0岁 116例 ,平均 5 6 .0 4岁。本组病例急性胰腺炎诊断标准为 :急性上腹疼痛 ,伴或不伴恶心、呕吐、腹…     

急性胰腺炎的预后因素(综合报道)

本文介绍了评估急性胰腺炎预后的因素,包括评分系统,腹腔灌洗液检查、影像学检查以及生物学参数等。     

急性胰腺炎患者血糖和血脂的变化及临床意义

为了探讨急性胰腺炎时对胰岛功能的影响 ,我们对急性胰腺炎患者的血糖变化以及糖尿病患者并发急性胰腺炎时的病情改变进行了研究。资料与方法1.临床资料 :收集 1996年 1月～ 1998年 12月我院外科收治的急性胰腺炎 16 9例 ,其中男 98例 ,女 71例 ;年龄 16～83岁。重症急性胰腺炎 42例 (ＡＰＡＣＨＥⅡ评分≥ 8分 ) ,男女之比为 1 5∶1,平均年龄 47岁 ,死亡 15例 ,死亡率为 36 % ;轻型急性胰腺炎 12 7例 (ＡＰＡＣＨＥⅡ评分 <8分 ) ,男女之比为1 4∶1,平均年龄 45岁。 12 7例轻型急性胰腺炎均痊愈出院。本组 16 9例急性胰腺炎中有糖尿病史者 …     

Correlation of clinical and computed tomographic findings for therapy and prognosis of acute pancreatitis

A prospective study was performed in 156 patients with acute pancreatitis to find out the value of computed tomography for the diagnosis and early prognosis. The CT finding leads to a diagnosis and differentiation in 3 risk groups similar to the clinical staging. The prognostic value of CT depends on the reproducible grading of pancreatic swelling and the grade of extrapancreatic fluid collections. CT finding correlates with early prognostic factors and the clinical staging, leading to different risk groups which allows an adequate stage-depending therapy of patients with acute pancreatitis.     

Improved prognosis in acute pancreatitis

An initial retrospective analysis of cases treated between 1963 and 1980 showed the main factors improving prognosis to be delayed operative treatment, radical removal of all necrotic tissue, post-operative use of irrigation and suction drainage. The prospective use of this regime during the years 1981 to 1982 resulted in an operative mortality of 29%. A further decrease in the operative mortality to 14% could be achieved in 1983 and 1984 by performing preoperative ERCP, because the knowledge of preexisting pancreatic fistulae and other pathologic changes of the duct system allow an individualized operative treatment adopted to the special problems of each cases.     

急性胰腺炎预后判断的多因素逐步回归分析

目的 探讨急性胰腺炎术前、中、后多种因素与预后的关系。方法 应用逐步回归分析法对我院经手术治疗的87例急性胰腺炎患者的病史、体征及治疗措施等多项指标进行分析,建立预测急性胰腺炎预后的方程式。结果 在调查的32个因素中有10项（胰腺炎病理类型和术后体温、嗜中性白细胞比率、营养方式和胆道病变性质、胆囊病变类型、胰腺皂化、麻醉方式、术前发热及患者年龄等）与急性胰腺炎恢复关系最大。结论 该回归方程对预测急性胰腺炎的预后及指导临床治疗、减少并发症和降低死亡率有重要的参考价值。     

骨密度与血糖、血脂及血尿酸水平相关性分析

目的分析骨密度和血糖、血脂及血尿酸水平的相关性。方法选择在本院体检的无基础疾病的健康人群,询问患者病史,测量身高、体重,计算体重指数。空腹采集肘静脉血,采用全自动生化分析仪检测:空腹血糖、总胆固醇、低密度脂蛋白胆固醇、血尿酸。测定骨密度(BMD),测定部位为:股骨颈(左侧)。结果血尿酸、血糖及低密度脂蛋白胆固醇水平在骨质疏松组高于骨量减少组及骨量正常组;血糖、血尿酸与骨密度T值呈相关关系(P值均0.05;相关系数分别为-0.35,-0.49),进一步的多元线性回归分析显示,血尿酸、空腹血糖均是影响骨密度的危险因素,且空腹血糖对骨密度的影响较大。结论空腹血糖、血尿酸升高是中老年人群骨密度下降的危险因素。     

Individualized prognosis of the infectious acute pancreatitis

The results of treatment of 125 patients, suffering severe forms of an acute pancreatitis (AP) are analyzed. Basing on the patients complex examination data, using the method of logistic regression, a mathematic model of individualized prognosis of the AP infected form presence after their admittance to hospital, was elaborated.