重视重症胰腺炎早期危险并发症

Focusing on the harmful complications of SAP in the early stages

目的:探讨重症急性胰腺炎的致死性关键因素,重视并采取加强型防治措施,以期提高治愈率,有效降低死亡率和后期并发症率。方法:对286例早期出现休克、肾衰、急性呼吸窘迫综合征(ARDS)、腹腔间室综合征(ACS)、胰性脑病、严重电解质酸碱紊乱等危险并发症的患者进行观察,高度重视并采取加强型防治措施,观察整体效果。设置对照组,进行对比分析。结果:治疗组治愈率、死亡率、后期胰腺脓肿和假性囊肿发生率、胆囊结石发生率分别为98.6%、1.4%、1.4%、2.8%,对照组治愈率、死亡率、后期胰腺脓肿和假性囊肿发生率、胆囊结石发生率分别为77.4%、22.6%、31.2%、17.2%,两组间差异有非常显著性(P<0.001)。结论:①重症急性胰腺炎早期出现休克等危重并发症是其高死亡率和高后期并发症率的关键因素。②重视这些因素,并采取加强型防治措施,可明显降低死亡率和后期并发症率,并且有效减少治疗费用。③中药在加强型措施中有显著的优越性。

Objective： To explore the critical factors which lead to mortality in SAP, and taking effective ways to reduce death rate and the occurrence of complications in SAP in late stages so as to improve the cure rate in SAP by taking proper measures on harmful complications. Methods： The 286 cases of early shock, renal failure, acute respiratory distress syndrome （ARDS）, abdominal compartment syndrome （ACS）, pancreatic encephalopathy, severe electrolyte acid-base disorders, such as the harmful complications observed in patients with a high degree of importance and enhanced prevention and control measures to be taken to observe the overall effect. Set in the control group and compared analysis. Results： In the treatment group, the cure rate, mortality, the latter part of pancreas pseudo cyst abscess and the incidence of gallstone occurrence rates were 98.6%, 1.4%, 1.4% and 2.8%. In the control group, the cure rate, mortality, the latter part of pancreas pseudo cyst abscess and the incidence of gallstone occurrence rates were 77.4%, 22.6%, 31.2% and 17.2% the difference between the two groups was significant （P〈0.001）. Conclusion： （1） Harmful complications such as shock are the critical factors which lead to high death rate in SAP. （2）Focusing on these factors and taking measures to strengthen the prevention and treatment type can significantly reduce the mortality and complication rates of the late, and effectively reduce the cost of treatment. （3）The Chinese traditional medicine has significant advantages in critical factors.