氧代谢监测在重症急性胰腺炎病程发展过程中的应用价值

目的探讨在急性胰腺炎并发多器官功能障碍综合征（MODS）发生发展中氧代谢监测的价值。方法选择121例各类急性胰腺炎患者,采集相关氧代谢检测数据和参数,比较水肿组和重症组,MODS和NMODS组,存活组与死亡组各指标间的变化,以水肿组相应指标测定结果作为对照,依据病性严重程度及并发MODS情况对病情或预后进行量化评价。结果氧代谢水平在重症胰腺炎发病后即发生异常,与严重程度、低血容量性休克、全身炎症反应综合征（SIRS）以及是否并发呼吸系统合并症等有关;并发MODS患者氧代谢水平变化更为明显,与水肿组对照组和NMODS组比较相关氧代谢比值改变均有显著性差异。结论氧代谢水平变化与重症急性胰腺炎并发MODS的发生发展密切相关,动态监测组织细胞氧代谢状况对MODS具有一定的意义。

THE APPLICABLE VALUE OF MONITORING OXYGEN METABOLISM IN THEEVOLUTION OF SEVERE ACUTE PANCREATITIS

Objective To explore the value of monitoring oxygen metabolism in the evolution of multiple organ dysfunction syndromes（MODS） associated with acute pancreatitis.Methods 121 patients with various acute pancreatitis were selected,from whom relative test data and parameters of oxygen metabolism were collected.Comparison of variation between different groups was realized in the following groups： acute edematous pancreatitis and severe acute pancreatitis,patients with MODS and non-MODS（NMODS）,survivors and non-survivors.The test result of corresponding indicators of acute edematous pancreatitis group was regarded as contrast and quantitative evaluation of state of illness and prognosis has been taken from the aspects of acute physiology,chronic health state of patients,the sever extent of acute pancreatitis and associated MODS.Results Oxygen metabolism level was found abnormal after the incidence of sever pancreatitis,it was related with severity,hypovolemic shock,systemic inflammatory response syndrome（SIRS）,and respiratory complications.It was more obvious in the patients with MODS when compared them with the contrast group of acute edematous pancreatitis and group of non-MODS（NMODS）,notable difference of change can be found in relative oxygen metabolism ratio.Conclusion The change of oxygen metabolism level is closely related with the occurrence and evolution of MODS in severe acute pancreatitis patients.Dynamic monitoring of oxygen metabolic status of tissues and cells has certain significance for MODS.