重症急性胰腺炎并胰性脑病危险因素分析_医学论文.docVIP

重症急性胰腺炎并胰性脑病危险因素分析_医学论文 重症急性胰腺炎并胰性脑病危险因素分析_医学论文 作者：郭佳, 黄宗文, 樊景云, 陈燕, 何馥倩 【摘要】 目的：探讨重症急性胰腺炎（severe acute pancreatitis, SAP）并发胰性脑病（pancreatic encephalopathy, PE）的危险因素。方法：回顾分析2005年1月至2006年12月收治的255例SAP患者的临床资料。31例SAP患者合并脑病，224例未合并脑病。分别总结其临床特点。结果：PE组Ranson评分以及急性呼吸窘迫综合征（acute respiratory distress syndrome, ARDS）、肾功能衰竭、低蛋白血症、低钙血症和高血糖发生率均高于非PE组；两组急性生理学及慢性健康状况评分Ⅱ评分、CT严重指数评分、血淀粉酶和脂肪酶值、肝功能衰竭发生率、感染率及手术率，差异无统计学意义。多因素分析结果表明ARDS和高血糖是PE发生的高危因素。非PE组的治愈率高于PE组。结论：PE的发生是多因素作用的结果，ARDS、高血糖的发生可能是其高危因素。 【关键词】 急性坏死性胰腺炎 胰性脑病 危险因素 　　Objective: To study the risk factors for severe acute pancreatitis (SAP) complicated by pancreatic encephalopathy (PE).Methods: Clinical data from 255 patients with SAP from January 2005 to December 2006 were reviewed. Thirty. Clinical characteristics of SAP patients in both PE group and nonPE group were analyzed.Results: Ranson scale and the incidence rates of acute respiratory distress syndrome (ARDS), renal failure, hypoproteinemia, hypocalcemia and hyperglycosemia in PE group were higher than those in nonPE group (0.05). There were no significant differences in acute physiology and chronic health evaluation Ⅱ and CT severity index scales, the activities of amylase and lipase, the incidence rate of liver function failure, the infection rate and the operability between the PE group and the nonPE group (Pgt0.05) . Multivariate logistic regression analysis showed that ARDS and hyperglycosemia were high risk factors. Cure rate in PE group was higher than that in nonPE group.Conclusion: Nosogenesis of PE is the result of multiple factors. ARDS and hyperglycosemia may be the high risk factors for PE. 　　Keywords: acute necrotizing pancreatitis pancreatic encephalopathy risk factors 胰性脑病（pancreatic encephalopathy, PE）是急性胰腺炎（acute pancreatitis, AP）危重难治并发症之一。我们对2005年1月至2006年12月期间我院收治的重症急性胰腺炎（severe acute pancreatitis, SAP）并发PE患者的临床资料进行了总结，以探讨其发病的危险因素。 　　1 对象与方法 　　1.1 病例来源 　　2005年1月至2006年12月收入四川大学华西医院治疗的AP病例，共纳入255例。 　　1.2 诊断标准 　　参考中华医学会消化病学分会胰腺疾病学组《中国急性胰腺炎诊治指南（草案）》