重症急性胰腺炎并发成人呼吸窘迫综合征临床治疗探讨

Clinical study of adult respiratory distress syndrome (ARDS) secondary to severe acute pancreatitis

目的 探讨重症急性胰腺炎并发成人呼吸窘迫综合征 (ARDS)的有效治疗方法。方法 对 1992年 8月至 1997年 7月 (第一阶段 )和 1997年 8月至 2 0 0 1年 8月 (第二阶段 )收治的重症急性胰腺炎并发ARDS病人治疗结果进行回顾性分析和总结。结果 第一阶段收治重症急性胰腺炎 2 3例 ,发生ARDS者 15例 ( 6 5 2 %) ,死亡11例 ,病死率 73 3%;第二阶段收治重症急性胰腺炎 34例 ,发生ARDS者 13例 ( 38 2 %) ,死亡 4例 ,病死率30 8%。结论 早期积极控制ARDS的发生、发展 ,重视腹部情况的处理 ,同时有效地控制感染 ,是降低ARDS发生率、提高治愈率的关键。

Objective To discuss the therapeutic measures of ARDS secondary to severe acute pancreatitis. MethodsRetrospectively analyse the therapeutic results of ARDS secondary to severe acute pancreatitis in the first phase of Aug.1992～July 1997 and the second phase of Aug.1997～Aug.2001.Results There were 23 cases of severe acute pancreatitis during the first phase and 15 cases suffered from ARDS (65.2%).Eleven cases of the 15 cases died.The mortality reached 73.3%.And there were totally 34 cases of severe acute pancreatitis,and 13 cases suffered from ARDS (38.2%).Four cases of the 13 cases died.The mortality was 30.8%.Compared with the first phase,the mortality significantly decreased (30.8% vs 73.6%).Conclusion Actively intervening the occurence and progression of ARDS in earlier phase,effectively treating the abdominal complications and timely controlling the infection are the keys to the decrease of the incidence of ARDS and the improvement of the prognosis.