40例急性出血坏死性胰腺炎APACHEⅡ积分的临床分析

CLINICAL ANALYSIS OF THE APACHE II SCORE IN 40 CASES OF ACUTE HEMORRAGIC AND NECROTIC PANCREATITIS

对４０例急性出血坏死性胰腺炎逐一进行了ＡＰＡＣＨＥⅡ积分（ａｃｕｔｅｐｈｙｓ－ｉｏｌｏｇｙａｎｄｃｈｒｏｎｉｃｈｅａｌｔｈｅｖａｌｕａｔｉｏｎⅡ）。比较了１２例非手术治疗与２８例早期手术治疗之急性出血坏死性胰腺炎的ＡＰＡＣＨＥⅡ积分及实际病死率。结果表明，急性出血坏死性胰腺炎的病死率随着ＡＰＡＣＨＥⅡ积分的增加而上升，并且非手术治疗较早期手术治疗的病死率明显下降。应首先给予针对胰腺以及全身的保守支持及监测治疗，早期手术治疗应慎重掌握适应证。ＡＰＡＣＨＥⅡ积分对急性出血坏死性胰腺炎的预后有判断作用。

he APACHE II(acute physiology and chronic health evaluation II)score was evaluated in40 cases of acute hemorragic and necrotic pancreatitis(AHNP). A comparison of APCHE II scoreto the rnortality rate in l2 non一operated and 2 early operated patients showed that the mortalityrose with the increase in APACHE II score and was much lower in non一operated patients. Thetreatment principle may be a systemic support and care of AHNP at the early stage after the di-agnosis is made and the indications of the operatiOn should be followed strictly.