95例急性重症胰腺炎临床治疗分析

CLINICAL ANALYSIS OF 95 CASES OF ACUTE HEMORRHAGIC NECROTIC PANCREATITIS

急性重症胰腺炎为病情凶险的急腹症,并发症多,常发生多脏器功能不全甚至衰竭(MODS或MSOF).死亡率高,发病率有上升趋势.本组95例中,81例(85.3%)伴有多脏器功能不全或衰竭,治愈78例(82.1%),死亡17例,病死率17.9%.提出:(1)具有明确的一般胰腺炎的症状和体征;(2)伴有或继发全腹腹膜炎,出现血性腹水且腹水淀粉酶增高;(3)伴有多器官功能不全或衰竭.作为急性出血坏死性胰腺炎的诊断标准是可靠的,是临床医生容易掌握的.在治疗过程中积极抗休克;及时纠正低氧血症;有效控制感染;加强中药通腑;严密监测各脏器功能是治疗成功的关键.

Acute hemorrhagic necrotic pancreatitis, (AHNP) is an acute abdominal condition with high motality and increasing incidence a complication such as multiple organ dysfunction syndrome (MODS) or multiple organ system failure (MOSF) often occured. In this artical we analysed 95 cases of AHNP, MODS or MOSF occured in 81 cases (85. 3%), the recovery and death rates are 82. 1% and 17. 9% respectively.Conclusion:The following reliable diagnostic criterias which can be easily understook by clincians : (1) common symptoms and signs of pancreatitis; (2) the presence of secondary peritonitis with bloody ascites and an increased level of ascitc amylase; (3) the presemce of MODS or MOSF. treatment of shock, correction of hypoxemia,effective control of infection, the use of Traditional Chinese Medicine and meticulous moritoring of organs function are the key to a successful treament.