急性胰腺炎并发胰性脑病19例临床分析
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金洲祥

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Acute pancreatitis complicated with pancreatic encephalopathy:a report of 19 cases
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    摘要:

    摘要:
    目的 探讨急性胰腺炎(AP)并发胰性脑病(PE)的诱发因素、预后及防治措施。
    方法 回顾性分析总结1999年1月~2004年5月收治的19例AP并发PE临床资料。
    结果 PE的发生率为12.0%, PE出现时常伴有高热、水和电解质代谢紊乱、低氧血症等因素。全组手术治疗11例,非手术治疗8例;死亡10例,病死率高达52.6%,明显高于同期收治的急性重症胰腺炎(SAP)病死率(20.7%,P<0.05)。
    结论 PE可能是在胰酶对大脑损害作用的基础上多种因素综合致病的结果, 预后差。PE的治疗仍应坚持SAP的“个体化治疗”原则 ,其手术指征与其他SAP是一致的 ,手术方式宜简单有效;PE不应作为独立的手术指征。

    Abstract:

    Abstract:Objective
    To discuss the predisposing factors,prognosis and treatment of pancreatic encephalopathy(PE) in acute pancreatitis(AP).
    Methods Nineteen cases of AP complicated with PE were retrospectively studied.
    Results The occurrence rate of PE was 12.0%. PE often occurred in association with such factors as hyperpyrexia, waterelectrolyte disturbance, and hypoxemia. Among the 19 patients,11 patients received surgical operation and 8 were treated conservatively.The total fatality rate reached 52.6%(10/19),significantly higher than other concurrently treated cases of severe acute pancreatits(SAP) (20.7%,P<0.05).
    Conclusions PE may result from the combined effect of several factors upon an underlying cerebral injury due to pancreatic enzymes.AP complicated with PE carried a poor prognosis.PE should be treated according to the "individualized therapy"principle of SAP,and operative indications should be the same as that of SAP.Operation should be simple and effective.PE should not be independently considered as an operative indication of SAP.

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金洲祥,李永国,黄生福,张威.急性胰腺炎并发胰性脑病19例临床分析[J].中国普通外科杂志,2005,14(5):8-.
DOI:10.7659/j. issn.1005-6947.2005.05.007

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  • 收稿日期:2004-07-15
  • 最后修改日期:2005-01-11
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  • 在线发布日期: 2005-05-25