急性胰腺炎并发胰性脑病17例分析

PANCREATIC ENCEPHALOPATHY DURING ACUTE PANCREATITIS (A REPORT OF 17 CASES)

回顾分析了急性胰腺炎并发胰性脑病（ｐａｎｃｒｅａｔｉｃ ｅｎｃｅｐｈａｌｏｐａｔｈｙ ，ＰＥ） 患者１７ 例，发现在ＰＥ 出现之前或同时均存在１ ～３ 种可能诱发或加重脑细胞功能障碍的因素，如低氧血症、血糖紊乱、水电解质紊乱、氮质血症、严重应激状态（ 手术、感染） 等。提示ＰＥ 可能是在胰酶对大脑损害作用的基础上多种因素综合致病的结果，因此，ＰＥ 不宜独立地作为重症胰腺炎的手术指征。中西医结合治疗本病有一定疗效，如经保守治疗病情仍有加重者，以及并发胰腺坏死组织感染或胰腺脓肿者则需配合手术治疗。

Seventeen cases of pancreatic encephalopathy (PE) with acute pancreatitis were studied retrospectively. It was found that on the basis of brain damage caused by pancreatic enzyme, many factor might play a role in the development of PE. It suggests that PE should not be accepted as an operative indication separately in severe acute pancreatitis. Chinese medicine can benefit the patient in the treatment of this disease. Operation is the only choice while patient get worsened even after appropriate and enough nonoperative therapy, as well as while pancreatic necrosis become infected or pancreatic abcess formed. Mortality of PE in this series is 52.9%, slightly less than the level (66.7%-100%) reported by other authors.