• 貴陽醫(yī)學院附屬醫(yī)院急診外科重癥監(jiān)護病房(貴陽550001);

目的  探討5例特重型胰腺炎的特點及治療方法。
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內(nèi)心跳、呼吸驟停3次的重癥急性胰腺炎(SAP)1例,治療以及時血液濾過和心、肺、腦復蘇為重點; SAP并發(fā)胰性腦病2例,以大劑量維生素B1的補充,或足量補給濃縮紅細胞為治療重點; 并發(fā)多個器官功能障礙的暴發(fā)性胰腺炎(FAP)2例,治療重點是血液濾過和防治多器官功能衰竭的級聯(lián)放大反應,其中1例以高滲性糖昏迷為主要表現(xiàn),治療重點是內(nèi)穩(wěn)態(tài)的糾正,血液濾過,重要器官功能維護。
結果  5例特重型胰腺炎患者均治愈,平均住院時間為32.2 d。
結論  器官功能的復蘇和維護、外科ICU監(jiān)護、短時血液濾過、內(nèi)穩(wěn)態(tài)的糾正、中西藥綜合治療及病因、對癥的個體化治療是特重型胰腺炎的重要治療措施。

引用本文: 李昆,孫早喜,張靜萍,白冰,孫誠誼,夏亮芳. 5例特重型胰腺炎治療分析. 中國普外基礎與臨床雜志, 2004, 11(6): 534-535. doi: 復制

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  1. 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. 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. 3. 陶京,王春友,楊智勇,等. 不同血濾方法治療重癥急性胰腺炎療效比較及適應證探討 [J]. 中華實驗外科雜志, 2003; 20(10)∶737.
  4. 4. Norman J. The role of cytokines in the pathogenesis of acute pancreatitis [J]. Am J Surg, 1998; 175(1)∶76.
  5. 5. Isenmann R, Rau B, Beger HG. Early severe acute pancreatitis: characteristics of a new subgroup [J]. Pancreas, 2001; 22(3)∶274.
  6. 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. 7. 王興鵬. 重視腸道衰竭在重癥急性胰腺炎發(fā)病中的作用 [J]. 中華消化雜志, 2002; 22(1)∶5.
  8. 8. 孫早喜,張靜萍,孫誠誼. 特異、特重型胰腺炎救治探討(附二例報告) [J]. 中華醫(yī)藥學雜志, 2003; 2(7)∶65.
  9. 9. 何振平. 急性胰腺炎的并發(fā)癥臨床認識與評價 [J]. 消化外科, 2003; 2(4)∶297.
  10. 10. Matz R.Management of the hyperosmolar hyperglycemic syndrome [J]. Am Fam Physician, 1999; 60(3)∶1468.