胰性脑病的临床分析与护理

目的探讨急性重症胰腺炎并发胰性脑病的护理对策,改善胰性脑病的预后。方法对12例急性重症胰腺炎并发胰性脑病的患者进行回顾性分析,了解其发生的危险因素和临床表现,并对早期护理方法进行总结。结果12例中发生在SIRS期9例,感染期3例。SIRS 3例死亡,均死于MOF,感染期1例死于严重感染并发MOF。其余患者症状缓解治愈出院。结论胰性脑病是急性重症胰腺炎的严重并发症,积极消除其各种诱因,有助于降低胰性脑病的发生率。

Clinical observation and nursing care of in severe acute pancreatitis patients with pancreatic encephalopathy

Objective To investigate the pathogenesis,clinical manifestations,diagnosis,differential diagnosis and nursing measures of pancreatic encephalopathy(PE) in Severe acute pancreatitis(SAP) and to modify the prognosis of PE.Methods Clinical data of 12 patients with PE in the past 3 years were collected and the pathogenesis,clinical manifestations,diagnosis and nursing measures were retrospectively analyzed.Results 12 cases of SAP were complicated with PE.9 cases of PE appeared in earlier period(SIRS period) and 3 cases in later period(infection period).Clinical manifestations of PE mainly included nerve system symptoms such as dysphoria,disturbance of orientation,illusion,somnolence and coma.Patients with PE also had symptoms of meningeal irritation signs,increased intracranial pressure.PE patients often had deeper eumycetes infection.3 cases of PE patients in SIRS period died of multiple organ failer(MOF) and 1 case of PE patient in infection period died of severe sepsis following MOF.The rest patients were recovered.Conclusions PE is one of severe complications of SAP.Eliminating causes of PE,early diagnosis and nursing care were important.As soon as final diagnosis of PE is made,it is helpful to decrease death rate of PE to take the rational therapy of pancreatitis,infection,nerve nutrition and nursing care.