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[急性胰腺炎并发肺损伤的影响因素及临床意义]

[Impact factors and clinical significance of the lung injury complicating acute pancreatitis].

作者信息

Yu Wen-Kui, Li Wei-Qin, Li Ning, Li Jie-Shou

机构信息

Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, Jiangsu, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2004 Feb;16(2):100-2.

Abstract

OBJECTIVE

To study the impact factors and clinical significance of the acute lung injury (ALI) complicating acute pancreatitis.

METHODS

Two hundred and fifty patients with acute pancreatitis were retrospectively analyzed to study the impact of the clinical types, different stages of the disease, systemic inflammatory response syndrome (SIRS) and its duration on the incidence of ALI. Also, the relationship between ALI and severity of the disease, as shown by acute physiology and chronic health evaluation II (APACHE II) score, the incidence of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndromes (MODS), and prognosis was analyzed in patients with acute pancreatitis.

RESULTS

Our data showed that the clinical types and different stages of acute pancreatitis were significantly related to the incidence of ALI (P<0.01). The incidence of ALI was significantly higher in patients with SIRS compared with those no SIRS (P<0.01), and the longer the duration of SIRS, the higher was the incidence of ALI. In patients with ALI, APACHE II score and incidence of ARDS and MODS (P<0.01) were significantly higher, and the prognosis was poor (P<0.05).

CONCLUSION

SIRS is an important factor that has strong influence on incidence of ALI, and the ALI is an important determinant of prognosis and severity of patients with acute pancreatitis.

摘要

目的

探讨急性肺损伤(ALI)并发急性胰腺炎的影响因素及临床意义。

方法

回顾性分析250例急性胰腺炎患者,研究临床类型、疾病不同阶段、全身炎症反应综合征(SIRS)及其持续时间对ALI发生率的影响。此外,分析急性胰腺炎患者中ALI与疾病严重程度(以急性生理与慢性健康状况评分系统II(APACHE II)评分表示)、急性呼吸窘迫综合征(ARDS)和多器官功能障碍综合征(MODS)发生率以及预后的关系。

结果

我们的数据表明,急性胰腺炎的临床类型和不同阶段与ALI的发生率显著相关(P<0.01)。与无SIRS的患者相比,SIRS患者的ALI发生率显著更高(P<0.01),且SIRS持续时间越长,ALI发生率越高。在ALI患者中,APACHE II评分以及ARDS和MODS的发生率显著更高(P<0.01),且预后较差(P<0.05)。

结论

SIRS是对ALI发生率有强烈影响的重要因素,而ALI是急性胰腺炎患者预后和严重程度的重要决定因素。

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