急性重症胰腺炎预后与Binder综合评分的关系

目的探讨重症胰腺炎(SAP)器官功能或代谢合并症Binder评分与SAP预后的关系。方法对莱阳市中心医院收治的85例SAP患者的资料进行回顾调查分析,了解SAP的并发症,如休克、ARDS、胰性脑病和全身感染发生率与SAP病死的关系,根据Binder积分估计SAP的预后。结果SAP85例,治愈66例(77.6%),病死19例,病死率为22.4%,发生各种并发症57例(67.1%)。ARDS、休克、胰性脑病和全身感染,其病死率分别为8.2%、7.1%、5.9%和4.7%。将SAP器官或代谢合并症综合评分分为≥7分组和<7分组,综合评分>7分组病死率非常显著高于评分<7分组(P<0.01)。结论休克、ARDS、胰性脑病和全身感染是SAP主要并发症和病死原因。Binder积分高低与其有关,积分越高,SAP预后越差,Binder评分高低不仅可以判定SAP病情轻重,而且估计SAP的预后。

The relationship of evaluation of severe acute pancreatitis by using Binder points and prognosis

Objective To investigate the relationship between Binder points and prognosis of severe acute pancreatitis(SAP).Methods The clinical data of 85 patients with SAP treated in author's hospital in the past 8 years were retrospectively analyzed,so as to explore the relationship of incidence rate of the complications of SAP such as shock,ARDS, pancreatic-brain disease and systemic infection, etc. and the mortality of SAP.Its prognosis was estimated based on Binder points.Results Of the 85 patients, 66(77.6%)were cured and 19 died(22.4%).The mortality was 22.4%.Seventy three patients (65.2%)had complications. The rates of complications related to mortality of ARDS,shock,pancreatic-brain disease and systemic infection were 8.2%,7.1%,5.9% and 4.7%,respectively. All the patients were divided into A group(≥7 points) and B group(<7 points) by the composite points based on the organic function failure or diabetic complications.The difference of mortality between the two groups was significant (P<0.01).Conclusions Shock,ARDS,pancreatic-brain disease and systemic infection are the main complications of SAP and major reasons for death.Binder points are correlated to these complications.The higher the pointsis,the worse the prognosisis.