33例重症急性胰腺炎死亡原因分析

目的 分析导致重症急性胰腺炎(SAP)死亡的原因.方法 回顾性分析瑞金医院近5年33例SAP死亡病例的临床资料,探讨早期高危因素对于SAP预后的关系.结果 在33例SAP病例中,发病1周内死亡的有16例,心脏骤停占55%,老年患者(>60岁)占78.8%;发病>1个月的死亡病例有12例,其中感染性休克6例(胰性脑病1例),MODS占10例(83.3%).结论 导致重症急性胰腺炎死亡的高危因素为高龄、多器官功能衰竭、感染、出血.临床上要重视重症急性胰腺炎的早期重要脏器功能的支持治疗,积极控制并发症,特别是高龄患者;手术时机的把握以及后期对于感染的控制是降低病死率的关键.

Analysis of the cause of death in 33 severe acute pancreatitis patients

Objective To analyze the cause of death in severe acute pancreatitis(SAP).Methods Thirty-three death cases with SAP during the past five years were retrospective analyzed in our hospital.The relevance between the early risk factor and prognosis in SAP was investigated.Results Sixteen cases died within a week after the onset of SAP,among these cases 55% were cardiac arrest.78.8% was aged patients.Twelve cases died in a month after onset of SAP,6 of them had septic shock(one case toxic encephalopathy),10 of them had MODS(83.3%).Conclusion The high risk factors resulted in death are elder age,MODS,infection and bleeding.We should pay attention to the support therapy of early organ function in SAP and control the complications actively,especially the aged patients.The operative opportunity and infection control in the late phase are the key points to decrease the mortality in SAP.