重症急性胰腺炎死亡的相关因素分析及治疗探讨

CLINICAL ANALYSIS OF 46 DEAD CASES OF SEVERE ACUTE PANCREATITIS

目的分析影响重症急性胰腺炎死亡率的因素和探讨治疗策略。方法回顾性分析46例SAP死亡病例的临床资料。结果与死亡率相关的高危因素为低氧血症、多器官功能衰竭、感染、SIRS和腹腔室隔综合征;FAP患者的死亡率明显要高于SAP患者。结论临床上要重视SAP的早期治疗,特别是FAP这一特殊类型。对高危因素的预防和治疗是降低死亡率关键。

Objective To investigate the factors influencing the mortality of severe acute pancreatitis （SAP） and the related problems during the treatment. Methods 46 cases of dead patients with SAP admitted from Jan 1990 to Jan 2004 were received, the major factor of death were rewiewed retrospectively, and anazlyed a special type ： fulminant acute pancreatitis （FAP）. Resaults The mortality of SAP patients is 16. 9% （46/272）. The high risk factors of death include hypoxaemia,mutiple organ dysfunction syndrome （MODS） ,infection,systemic inflammatory response syndrome（SIRS） and abdominal compartment syndrome（ACS）. The mortality of FAP is higher than SAP. Conclusions The early treatment of SAP, specially FAP should been attached importance to. The key of reduction the mortality is preventing and treatment of these high risk factors.