重症急性胰腺炎伴成人呼吸窘迫综合征的救治

目的：探讨如何降低ＳＡＰ所伴发的ＡＲＤＳ的发病率及救治方案。临床资料：１９９１．１￣１９９８．１２ＳＡＰ病人５４例。手术组３１例，三天内手术１２例，发生ＡＲＤＳ７例，死亡６例；三天后手术１９例，发生ＡＲＤＳ４例，死亡１例。非手术组２３例，早期（三天内）发生ＡＲＤＳ５例，死亡３例，后期发生ＡＲＤＳ２例，死亡１例。一旦明确ＳＡＰ诊断，给予积极抗休克，有计划的手术，控制感染，营养支持。一旦出现难于纠正的

The treatment of adult respiratory distress syndrome in patients with sever acute pancreatitis

Objective: To study how to reduce the incidence of the adult respiratory distress syndrome (ARDS) caused by severe acute pancreatitis and ameliorate its therapeutic efficacy. Clinical materials: From Jan. 1991 to Dec. 1998, 54 patients received the treatment. Among them, 7 out of 12 patitents operated within 3 day after admission had complicated ARDS with 6 deaths,ARDS occurred in 4 out of 19 patients operated in 3 days after admission with 1 death,23 patients who received non-operative treatment only had 5 cases complicated with ARDS in 3 days after admission with 3 death and 2 cases suffered from ARDS in the late stage,also with one death. Therefore, we suggest that the combined intensive treatment instead of operation or any other single therapeutic measure should be considered as the utmost important measure in the treament of severe acute pancreatitis. The powerful anti-shock, effective control of infection, supplementary nutritional support and a scheduled surgery must be carried out reasonably and at an appropriate time. If low blood oxygen concentration can not be corrected,prompt endotracheal tube or tracheostomy must be done as earlier as possible. PEEP may be suitable for such patients.Conclusion: The multiple therapies must be taken for the treatment of severe acute pancreatitis. To improve the low blood oxygen concentration is the major procedure in the prevention of the occurrence of ARDS.