重症胰腺炎并发ARDS治疗实践.doc

重症胰腺炎并发ARDS治疗的实践与体会 【摘要】目的 探讨急性呼吸窘迫综合症(ards)在重症胰腺炎治疗过程中的临床意义。方法 对43例重症胰腺炎并ards的病因、发病机理和相关因素、治疗效果进行回顾性分析，重视原发病的治疗，加强肺保护，是提高预防与治疗效果的重要措施。结果 重症胰腺炎存活43例，重症胰腺炎病程中合并ards 19例，无死亡病例，存活率100％。其中手术干预20例。结论 重症胰腺炎在及时处理原发病的基础上，对并发的ards进行早期诊断和治疗，正确使用呼吸机，防治并及时处理其它并发症，是降低病死率的有效措施。 【关键词】重症胰腺炎 呼吸窘迫综合症(ards)临床分析 治疗方法 中图分类号：r576文献标识码：b文章编号：1005-0515（2011）11-119-02 experience of treatment on severe pancreatitis complicated with ards xu mei li hu jiang shukun peng yongfen fan shaominhuang kun ( yunnan richland hospital, kunming yunnan) 【abstract】objective to investigate the clinical significance of acute respiratory distress syndrome(ards) in the treatment of severe acute pancreatitis. methods 43 patients with severe pancreatitis were retrospectively analyzed for their etiology, pathogenesis and treatment. treatment of primary diseases was emphasized and lung protection was strengthened on these patients. results of the 43 patients, all of them survived, the survival rate being 100.00%. 19 patients among 43 patients developed ards and all of them survived, the survival rate being 100.00%. among 20 patients, surgical interventions were carried out. conclusion on the basis of timely intervention of primary diseases and carefully prevention of other complications, early diagnose and treatment of ards with appropriate use of ventilator is an effective measure to improve the survival rate of severe pancreatitis. 【key words】severe pancreatitis acute respiratory distress syndrome (ards) clinical analysis treatment 重症胰腺炎是一种发病急骤、变化迅速、病情危重复杂的全身性疾病，它除了胰腺本身的缺血、坏死，更多的表现为全身多脏器功能的紊乱。特别是急性呼吸窘迫综合征(acute respiratory distress syndrome, ards)在重症胰腺炎患者中往往首先出现，其临床表现为低氧血症和呼吸困难，是发生多器官衰竭(multiple organs failure, mof)和患者死亡的重要原因。 因此如何防止ards的发生，以及一旦发生ards如何及时治疗，对于提高sap的疗效有着重要作用。本文分析了重症胰腺炎并发ards的临床特点，介绍了有关治疗实践和体会。 1 资料与方法 本院自2000年～2011年共收治重症胰腺炎患者43例，其中男37例，女6例；年龄32～70岁，平均50.4岁；重症胰腺炎诊断符合中华医学会外科学会胰腺学组制订的急性胰腺炎临床诊断及分级标准[1]。其中并发ards 19例，男15例，女4