重度烧伤并发以低血糖为特征的重症急性胰腺炎一例

One case of severe burn complicated with severe acute pancreatitis characterized by hypoglycemia

2018年2月14日笔者单位收治1例火焰烧伤总面积为20%体表总面积的44岁男性患者。患者入院时腹部CT无明显异常,伤后11h出现左上腹痛,伴尿量减少,后突发低血糖、低血压,复查腹部CT明确为急性胰腺炎,经积极抢救血糖恢复缓慢,胰腺炎病情进展迅速,家属放弃治疗,患者自动出院。该病例提示临床医师要关注严重烧伤患者的血糖水平变化,警惕患者并发伤后胰腺炎。

A 44 years old male patient suffered from flame burn of 20% total body surface area was admitted to our hospital on February 14th, 2018. On admission, his abdominal CT was not obviously abnormal. Eleven hours after burn, the patient had left upper abdominal pain, accompanied by reduction of urine output. Then he suffered from sudden hypotension and hypoglycemia. Acute pancreatitis was diagnosed by abdominal CT reexamination. Low glucose level was ameliorated slowly through positive rescue, and pancreatitis crisis progressed rapidly. The family members gave up rescue care, and patient discharged. The case indicates that physicians should pay attention to glucose levels of severe burn patients, and be cautious of appearance of postburn pancreatitis.