重症急性胰腺炎并发ALI/ARDS24例临床分析

DIAGNOSIS AND TREATMENT OF ALI/ARDS COMPLICATED BY SEVERE ACUTE PANCREATITIS

目的 探讨重症急性胰腺炎并发急性肺损伤 ( AL I) /急性呼吸窘迫综合征 ( ARDS)的证断与治疗。方法 回顾性分析本院 1997年 1月至 2 0 0 0年 12月收治的 2 8例重症急性胰腺炎中并发的 2 4例 AL I/ ARDS患者。结果 重症急性胰腺炎并发 AL I/ ARDS的发病率高达 85 .7% ,2 0例为 ALI,4例为 ARDS,均治愈。结论 在重症急性胰腺炎的急性反应期 ,应反复测定血气分析 ,不应拘泥于动脉氧分压数值 ,当氧合指数 ( Pa O2 / Fi O2 )≤ 30 0 mm Hg,可早期证断出 ALI,经积极处理 。

Objective To explore the diagnosis and treatment of ALI/ARDS complicated by severe acute pancreatitis(SAP).Methods Retrospectioely analyzed 24 cases with ALI/ARDS in the group of cases with SAP form Jan,1997 to Sep,2000 in our hospital.Results The incidence of ALI/ARDS complicated by SAp is 85.7 per cent,that contain 20 cases with ALI and 4 cases with ARDS.All patients recovered.Conclusion We must assay blood gas repeatedly during acute response period of SAP.Rigidly adhere to P aO 2 is not proper.ALI can be diagnosed early when oxygenate index(P aO 2)is below or equal to 300 mmHg.To avoid ALI developing into ARDS,it shoud be treated positively.