重症急性胰腺炎术后并发症和死亡原因分析

目的分析重症急性胰腺炎术后并发症和死亡原因. 方法回顾分析142例重症急性胰腺炎手术治疗前后的资料进行统计分析. 结果本组共55例出现并发症,其发生率为38.7%,术后主要并发症为腹腔感染、肺部感染、胸腔积液、假性囊肿、消化道出血、急性呼吸窘迫综合征(ARDS)、多脏器功能障碍综合征(MODS)、肠瘘、胰性脑病、真菌感染等;术后死亡23例,死亡率16.2%,死亡原因为ARDS、MODS、脓毒性休克、消化道出血和胰性脑病等;感染、年龄>60岁、手术时机和方式的选择是影响死亡的主要因素. 结论控制感染和正确选择手术时机及方式对降低死亡率尤为重要.

Postoperative Complications and Mortality in Patients with Severe Acute Pancreatitis

OBJECTIVE To analyze the postoperative complications and mortality in patients with severe acute pancreatitis(SAP). METHODS From Jan 1990 to Dec 2002,142 cases of SAP have been treated surgically. RESULTS Fifty-five patients (38.7%) had complications including abdominal infection,lung infection,hydrothorax,pseudocyst,ARDS,digestive tract bleeding, MODS, gastrointestinal fistula,pancreatic encephalopathy, and fungal infection.Twenty-three patients(16.2%) died of ARDS, MODS,septic shock, digestive tract bleeding or pancreatic encephalopathy.The main relative factors of mortality were: infection,age over 60,operation time and operation method. CONCLUSIONS It is important for us to control infection and choose operation time and method correctly in patients with severe acute pancreatitis.