目的了解重症急性胰腺炎(SAP)并发症与病死率的关系。方法对19年来我院肝胆外科收治的112例SAP患者进行回顾性总结分析。结果112例中,治愈92例(82.1%),死亡20例(17.9%),发生各种并发症73例(65.2%)。手术治疗73例(65.2%),治愈58例(79.5%),死亡15例(20.5%)。非手术治疗39例(34.8%),治愈34例(87.2%),死亡5例(12.8%)。手术治疗组和非手术治疗组间治愈率和死亡率差异无统计学意义(Pgt;0.05)。与病死率有关的并发症为休克、肺功能不全、胰性脑病和全身感染,其病死率分别为7.1%、6.3%、5.4%和3.6%。SAP并发症综合评分大于7分组和小于7分组比较,病死率差异有显著性意义(P<0.01)。结论SAP患者是死于其并发症,而并发症中休克、肺功能不全、胰性脑病和全身感染是致死的最主要原因。
Objective To study a simple and practical method of isolation, culture and identification of hepatic oval cells from adult rat. Methods Wistar adult rats were fed by 2-acetaminofluorere (AAF) and were stimulated by partial hepatectomy to activate the proliferation of hepatic oval cells. After operation 12 days, the livers were resected for isolating oval cells. Hepatic tissue was digested by 0.10% collagenase Ⅳ and the obtained heterogeneous liver cells were then isolated and purified by density gradient centrifugation. The expressions of albumin and CK19 mRNA in hepatic oval cells were analyzed by immuno-fluorescence and RT-PCR. Results The survival rate of the newly isolated oval cells was more than 90%. The hepatic stem cells were shown by immuno-fluorescence of stem cell’s antigen c-kit. The expressions of mRNA CK19 and albumin of the oval cell were also detected by PCR. The proliferation activity of the newly isolated oval cells was significantly high and they could be induced to differentiate into both hepatic and bile ductal cells by some growth factors. Conclusion The successful development of the simple and feasible isolation and purification procedure as well as the identification method for hepatic oval cells may provide a fundamental for further studies about bionomics of the hepatic stem cell and the relation between stem cells and hepatic carcinoma.