目的 探讨5例特重型胰腺炎的特点及治疗方法。
方法 我院2001年8月至2003年8月共收治特重型胰腺炎患者5例。其中入院后18 h内心跳、呼吸骤停3次的重症急性胰腺炎(SAP)1例,治疗以及时血液滤过和心、肺、脑复苏为重点; SAP并发胰性脑病2例,以大剂量维生素B1的补充,或足量补给浓缩红细胞为治疗重点; 并发多个器官功能障碍的暴发性胰腺炎(FAP)2例,治疗重点是血液滤过和防治多器官功能衰竭的级联放大反应,其中1例以高渗性糖昏迷为主要表现,治疗重点是内稳态的纠正,血液滤过,重要器官功能维护。
结果 5例特重型胰腺炎患者均治愈,平均住院时间为32.2 d。
结论 器官功能的复苏和维护、外科ICU监护、短时血液滤过、内稳态的纠正、中西药综合治疗及病因、对症的个体化治疗是特重型胰腺炎的重要治疗措施。
Citation:
李昆,孙早喜,张静萍,白冰,孙诚谊,夏亮芳. Analysis of Clinical Management in Patients with Severe Acute Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2004, 11(6): 534-535. doi:
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- 1. Bank S, Singh P, Pooran N, et al. Evaluation of factors that have reduced mortality from acute pancreatitis over the past 20 years [J]. J Clin Gastroenterol, 2002; 35(1)∶50.
- 2. Bosscha K, Hulstaert PF, Hennipman A, et al. Fulminant acute pancreatitis and infected necrosis: results of open management of the abdomen and “planned” reoperations [J]. J Am Coll Surg, 1998; 187(3)∶255.
- 3. 陶京,王春友,杨智勇,等. 不同血滤方法治疗重症急性胰腺炎疗效比较及适应证探讨 [J]. 中华实验外科杂志, 2003; 20(10)∶737.
- 4. Norman J. The role of cytokines in the pathogenesis of acute pancreatitis [J]. Am J Surg, 1998; 175(1)∶76.
- 5. Isenmann R, Rau B, Beger HG. Early severe acute pancreatitis: characteristics of a new subgroup [J]. Pancreas, 2001; 22(3)∶274.
- 6. Wang X, Wang B, Wu K, et al.Growth hormone downregulate the excess apoptosis of intestinal epithelial cells in rats during the early course of acute necrotizing pancreatitis [J]. Pancreas, 2002; 25(2)∶156.
- 7. 王兴鹏. 重视肠道衰竭在重症急性胰腺炎发病中的作用 [J]. 中华消化杂志, 2002; 22(1)∶5.
- 8. 孙早喜,张静萍,孙诚谊. 特异、特重型胰腺炎救治探讨(附二例报告) [J]. 中华医药学杂志, 2003; 2(7)∶65.
- 9. 何振平. 急性胰腺炎的并发症临床认识与评价 [J]. 消化外科, 2003; 2(4)∶297.
- 10. Matz R.Management of the hyperosmolar hyperglycemic syndrome [J]. Am Fam Physician, 1999; 60(3)∶1468.