• 重症急性胰腺炎并发急性呼吸窘迫综合征临床研 不要轻易放弃。学习成长的路上,我们长路漫漫,只因学无止境。


    关键词:重症急性胰腺炎;急性呼吸困顿综合征

    ???? 【摘要】? 倾向? 探讨重症急性胰腺炎(SAP)合并ARDS的临床特点和医治。方式? 67例SAP患者,在病发24h内监测动脉血气,举行胸部X线检讨。了局? 67例SAP患者,并发ARDS 23例(34.33%),PaO2<60mmHg时并发ARDS的比率超过60%,而PaO2<32mmHg时有90%摆布会产生ARDS。近50%的患者涌现肺部X线胸片检讨的异常。论断? SAP患者应举行呼吸功效检测,以便晚期发觉ARDS病例,采用无效医治措施,下降殒命率。

    ??? 【关键词】? 重症急性胰腺炎;急性呼吸困顿综合征

    ????? Clinical analysis of ARDS induced by severely acute pancreatitis

    ???? 【Abstract】? Objective? To study the clinical features and treatment of acute respiratory distress syndrome (ARDS) secondary to severe acute pancreatitis (SAP).Methods? A total of 67 patients diagnosed with SAP were enrolled in the study;patients were monitored for study arterial blood gas and chest-X- 葡京赌场最新网址,澳门新葡京平台网址,澳门新葡京在线ray were examined within 24 hours after SAP.Results? 23 patients among 67 patients of SAP developed ARDS (34.33%). The percentage of patients who developed ARDS with PaO2<60mmHg was above 60%.While the percentage of patients who developed ARDS with PaO2<32mmHg was about 90%. 50% of SAP patients appeared lung abnormalities by X-ray examination.Conclusion? The respiratory function of SAP patients should be carefully observed so that we could find the development of ARDS in early stage.

    ??? 【Key words】? severe acute pancreatitis;acute respiratory distress syndrome(ARDS)

    ??? 重症急性胰腺炎(SAP)病发急骤、转变迅速、病情危重而庞杂,预后欠安,病死率较高。急性呼吸困顿综合征(ARDS)是SAP的首要并发症之一,其临床表现为低氧和呼吸难题。是产生多器官衰竭(MOF)和患者殒命的首要缘由。本研究旨在对SAP并发ARDS举行临床特点的剖析,并会商其医治体会。

    ??? 1? 材料与方式

    ??? 1.1? 普通材料? 2000年1月~2005年12月我院消化科收治SAP患者67例,此中男37例,女30例;年齿32~70岁,均匀50.42±14.79岁;SAP诊断合乎中华医学会内科学会胰腺学组制定的急性胰腺炎临床诊断及分级尺度[1],此中并发ARDS 23例,男16例,女7例;年齿32~67岁。ARDS诊断合乎中华医学会呼吸病学分会制定的ARDS诊断尺度[2]。

    ??? 1.2? SAP并发ARDS的辨认? 对SAP患者紧密视察性命体征,检测血、尿淀粉酶、外周血白细胞计数、血糖、电解质等。病发24h以内监测动脉血气和胸部X线片的晚期转变,以便晚期辨认SAP并发的ARDS。

    ??? 1.3? 医治方式? SAP确诊后局部执行守旧医治,包孕禁葡京赌场最新网址,澳门新葡京平台网址,澳门新葡京在线 食,胃肠减压,纠正水、电解质及酸碱平衡错乱,增进肠爬动,使用能透过血-胰屏障的抗生素,成长抑素(施他宁)按捺胰腺排泄,全胃肠外养分(TPN)或肠内养分(EN)支撑。23例并发ARDS患者在医治原病发的同时,行经鼻或口气管插管给氧。

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