急性出血坏死型胰腺炎20例临床分析及治疗体会

Acute haemorrhagic pancreatitis:an Analysis of 20 cases and experiences in the treatment

本文通过对急性出血坏死型胰腺炎临床表现,辅助检查及预后关系的分析,指出应注意尿常规、肾功能、血糖、血钙、呼吸功能及血、尿、腹水淀粉酶的监测,以早期诊断;还指出本病因高胰酶血症及血管活性物质的活化,释放常引起ARDS、休克、急性肾衰、胰性脑病等多脏器功能障碍,甚而衰竭;造成预后不良应尽早防治。本文还强调本病应采取综合治疗措施,其中禁食、胃肠减压、静滴5—FU及使用中药清胰汤疗效较肯定,作者认为可列为本病治疗常规,一旦确定本病,内科治疗无效时,应尽早手术,以改善预后,提高疗效。

The relationship between the clinical manifestations, laboratory examinations and the prognosis of acute haemorrhagic pancreatitis(AHP)was analysed. It was pointed out that, for early diagnosis of AHP, urine routine, renal function, blood glucose and calcium levels, and respiratory function, as well as amylase levels in the blood, urine and ascites should be carefully monitored. Because hyperamylasemia and the activation and release of vaso-active subs-tances often result in multiple organ disorder or even failure such as ARDS, shock, acute renal failure and pancreatic encephalopathy. Preventive and therapeutic measures should be taken as early as possible. It is emphasized that comprehensive measures must be used in the treatment of AHP. Diet restriction, nasogastric suction, infusion of 5-FU and traditional Chinese medicine, Qing Yi Tang, are proved to be effective therapies and may be used as routine therapies for AHP. When medical treatment is ineffective, operation must be performed as early as possible in order to improve the prognosis and therapeutic effectiveness.