中重度急性胰腺炎患者的临床特点和生存状况研究

Clinical features and survival studies of patients with moderately severe and severe acute pancreatiti

〔目的〕探讨新的分类方法下中度和重度急性胰腺炎临床特征及生存状况的区别,以指导临床分类、预后判断和治疗。〔方法〕我院自2013年3月至2015年3月共收治82例急性重症胰腺炎(SAP)患者,根据《急性胰腺炎分类·2012》将其分为中度急性胰腺炎组(MSAP组)和重度急性胰腺炎组(SAP组),回顾性分析两组患者的临床资料,比较两组患者的性别、年龄、病因、合并基础疾病比例、发病至入院时间等一般情况,APACHEⅡ评分、Ranson、SIRS、改良Marshall评分、BISAP评分及血细胞比容、CRP、血乳酸脱氢酶、血肌酐、血尿素氮等生化指标及病死率。〔结果〕两组患者在性别、病因、发病至入院时间、血细胞比容、SIRS评分无显著差异(P>0.05),SAP组患者年龄、合并基础疾病比例、CRP、血乳酸脱氢酶、血肌酐、血尿素氮、PACHEⅡ评分、Ranson、改良Marshall评分、BISAP评分、病死率均显著高于MSAP组(P<0.05)。〔结论〕新的分类标准对于区分中度和重度胰腺炎患者具有十分重要的意义,可以用于更准确地评估病情,并指导治疗、判断预后。

〔O bjective〕To investigate the difference of clinical characteristics and living conditions between moderate and severe acute pancreatitis under the new classification methods to guide clinical classification, prognosis and treatment.〔M ethods〕82cases of severe acute pancreatitis（ SAP） patients were treated from March 2012 to March 2014, who will be divided into moderately severe acute pancreatitis（ MSAP group） and severe acute pancreatitis（ SAP group） according to ＂acute pancreatitis classification 2012 ＂. clinical data of two groups were retrospectively analyzed in gender, age, etiology, the proportion of complication, time of disease onset to hospitalization, etc; APACHE Ⅱ score, Ranson, SIRS, modified Marshall score,BISAP score and other scores; hematocrit, CRP, blood lactate dehydrogenase, serum creatinine, blood urea nitrogen and other biochemical parameters, as well as hospital costs, mortality and other prognostic indicators.〔R esults〕There were no significant difference in gender, etiology, time of onset, hematocrit, SIRS score, length of hospital stay（ P〉0. 05）, patient age the proportion of complication, hematocrit, CRP, blood lactate dehydrogenase, serum creatinine, blood urea nitrogen APACHE Ⅱscore, Ranson, modified Marshall score, BISAP score, hospital costs, length of stay,mortality of SAP group were significantly higher than MSAP group（ P〈0. 05）. 〔C onclusion〕The new classification criteria for distinguishing patients with moderate and severe pancreatitis has great significance, which can be used to assess the patient＇s condition more accurately, and guide therapy and prognosis.