胰性脑病的中文文献15年回顾

Review of the Chinese Literature about Pancreatic Encephalopathy in Recent 15 Years

目的 探讨胰性脑病的可能的发病机制、发病情况及防治措施。方法 计算机检索中文科技期刊全文数据库(1989～2004),收集有关胰性脑病的临床研究,并进行统计分析。结果 共纳入43篇文献,435例患者。胰性脑病在重症急性胰腺炎中的发病率远高于轻症急性胰腺炎;发病年龄趋向中、老年;病死率为43 67%;病因仍以胆系疾病为主;伴发低氧的几率不高于未并发胰性脑病患者。结论 胰性脑病的发生可能是多因素共同作用的结果,仍需进一步探讨其发病机制。血清髓鞘碱性蛋白有望成为有价值的诊断指标。防治以治疗原发病急性胰腺炎为主,重在预防。胰酶抑制剂和早期营养支持有一定预防作用。

Objective To explore the morbidity, pathogeny, mechanism, prevention and treatment of pancreatic encephalopathy (PE) in acute pancreatitis (AP) Methods We searched Database of Chinese Scientific and Technical Periodocals (19892004) Clinical studies on PE were identified and analyzed Results Forty three studies involving 435 patients were included. The morbidity of PE in severe acute pancreatitis (SAP) was much more than that of mild acute pancreatitis (MAP), Most of the patients with PE were adult and old people. The mortality in patients with PE was 43 67%. The pathogeny was often from biliary system diseases. There was no significant difference on the incidence of hypoxia in the patient with or without PE Conclusions The attack of PE is probably a result of multi factors and more studies on the mechanism are warranted Myelin basic protein is considered as a hopeful maker of diagnosis More efforts should be focused on the treatment of primary AP in the process of the prevention of PE Timely and effectively therapeutic ways including pancreatic enzymes inhibitor and early nutrition support will make some effect