摘要
目的总结分析重症高脂血症性胰腺炎（severe hyperlipidemic pancreatitis，SHLP）的临床特点，探讨其治疗经验。方法收集宣武医院2000年1月1日至2006年12月31日收治的22例SHLP患者，并与同期收治的91例重症胆源性胰腺炎（severe biliary panereatitis，SBP）进行比较，观察患者的血、尿淀粉酶及血三酰甘油水平，入院时的Ranson评分，入院前3d的APACHE11评分均值，胰腺BahhazarCT评分，循环、呼吸、肾功能不全发生率，胰腺感染、胰腺囊肿、肺部感染发生率及病死率。结果SHLP患者的血、尿淀粉酶、血三酰甘油水平，Ranson评分，APACHEⅡ评分，胰腺CT评分，循环、呼吸、肾功能不全发生率，胰腺感染、胰腺囊肿、肺部感染发生率和病死率分别为（715±99）U／L、（382±56）U／L、（17．8±6．2）mmol／L、5．22±0．33、14．65±2．91、5．85．±1．17、36．4％、40．9％、22．7％、22．7％、22．7％、54．5％和9．0％；SBP患者分别为（1551±107）U／L、（773±66）U／L、（4．6±0．9）mmol／L、4．19±0．67、10．34±2．18、5．11±1．12、14．3％、6．6％、5．5％、23．1％、24．2％、31．9％和12．1％。SHLP患者血、尿淀粉酶明显低于SBP者；而循环、呼吸、肾功能不全发生率和肺部感染率明显高于SBP者。结论诊断时应注意SHIP患者常不伴有血、尿淀粉酶的显著升高；治疗过程中应注意预防和积极治疗循环、呼吸和肾功能不全。
Objective To summarize the clinical profiles and treatment experience of severe hyperlipidemic panereatitis （SHLP）. Methods A retrospective study was carried out to compare clinical characteristics on 22 cases of SHLP, and the serum and urine levels of amylase, triacylglyeerol, Ranson scores, APACHE Ⅱ scores, Balthazar CT scores, incidences of circular, respiratory and renal insufficiency, pancreatic infection, pancreatic cyst, pulmonary infection and mortality were compared with those parameters of 91 patients with severe acute gallstone pancreatitis （SBP）. Results The serum and urine levels of amylase, triacylglycerol, Ranson scores, APACHE Ⅱ scores, Bahhazar CT scores, incidences of circular, respiratory and renal insufficiency, pancreatic infection, pancreatic cyst, pulmonary infection and mortality in SHLP group were （715 ±99）U/L, （382 ±56）U/L, （17.8 ±6.2）mmol/L, 5.22 ±0.33, 14.65 ±2.91, 5.85 ±1. 17, 36.4%, 40.9%, 22.7%, 22.7%, 22.7%, 54.5% and 9.0%, respectively; the corresponding values of SBP patients were （ 1551 ± 107 ） U/L, （ 773 ± 66 ） U/L, （ 4.6 ± 0. 9） mmol/L,4.19 ± 0.67,10.34 ± 2.18,5.11 ± 1.12,14.3% ,6.6% ,5.5% ,23. 1% ,24.2% ,31.9% and 12.1% , respectively. The levels of serum and urine amylase in SHLP were significantly lower than those of SBP. But SHLP patients had significantly higher incidence of circulation failure, respiration failure, renal failure and pulmonary infection. Conclusions In the process of diagnosis of SHLP , it should be noted that the elevation of blood and urine amylase may not be remarkable. In the management of SHLP, it was important to prevent and treat circular, respiratory and renal insufficiency.
出处
《中华胰腺病杂志》
CAS
2009年第3期147-149,共3页
Chinese Journal of Pancreatology
关键词
胰腺炎
急性坏死性
高脂血症
对比研究
Pancreatitis, acute necrotizing
Hyperlipidemia
Comparative study
