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目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)合并胰性脑病的临床预防和治疗措施。方法按不同时间段回顾性研究1987年1月至2006年12月收治的22例 SAP 合并胰性脑病患者的临床资料。研究分为2组,A 组(1987年1月至1996年12月)13例;B 组(1997年1月至2006年12月)9例,结合 SAP 治疗措施的差异分析胰性脑病的发生情况、临床表现、治疗过程等。结果 A 组中早期胰性脑病(EPE)8例,迟发性胰性脑病(DPE)5例,此期仅1例 EPE 存活,病死率为92.3%。B 组均为 EPE 病例,无一例死亡。死亡病例集中在前10年,均合并多器官功能衰竭。B组胰性脑病病例集中在前5年(1997年1月至2001年12月),近5年没有发现胰性脑病病例。结论积极消除各种诱因、治疗原发病和营养支持等有助于降低胰性脑病的发生率及病死率。
Objective To investigate the clinical prevention and treatment of severe acute pancreatitis (SAP) complicated with pancreatic encephalopathy. Methods The clinical data of 22 patients with SAP complicated with pancreatic encephalopathy were retrospectively studied from January 1987 to December 2006 at different time intervals. The study was divided into two groups, group A (January 1987 to December 1996) in 13 cases; group B (January 1997 to December 2006) in 9 cases, combined with SAP treatment of differences in the analysis of pancreatic encephalopathy Situation, clinical manifestations, treatment process and so on. Results In group A, there were 8 cases of early stage pancreatic encephalopathy (EPE) and 5 cases of delayed encephalopathy (DPE). Only 1 case of EPE survived in this group with a mortality rate of 92.3%. B group were all EPE cases, none of them died. The deaths were concentrated in the first 10 years, all with multiple organ failure. B group of pancreatic encephalopathy cases concentrated in the first 5 years (January 1997 to December 2001), nearly 5 years did not find cases of pancreatic encephalopathy. Conclusion The positive elimination of various incentives, treatment of primary disease and nutritional support can help reduce the incidence of pancreatic encephalopathy and mortality.