Lutfarakhmanov I I, Timerbulatov V M, Mironov P I, Ishmukhametov I Kh
Khirurgiia (Mosk). 2006(6):11-5.
The relationships between outcomes of severe acute pancreatitis (SAP) and organ dysfunction in 72 patients were studied. A total of 39 (54.2%) patients had organ dysfunction, 20 (27.8%) patients -- multiple organ dysfunction (MOD), 19 (26.4%) patients -- dysfunction of single organ or system. Died patients had higher incidence of MOD compared with those who alive (88.2 vs 9.1%, p<0.01). In multiple logistic regression analysis the main predicting factors of death were pulmonary failure and neurological dysfunction. Pulmonary failure was the most common organ dysfunction among both single organ dysfunction (57.9%) and MOD (95.0%), with a total morbidity of 41.7%. Mortality rate was lower at isolated pulmonary dysfunction, and was higher at MOD (18.2 vs 78.9%, p<0,01). Irregular specialized intensive treatment protocol led to groundless surgical interventions at 10 from 46 patients with sterile pancreonecrosis. Organ dysfunction makes worse the prognosis in patients with SAP. Choice of the optimal treatment strategy at SAP with MOD is determinative.
对72例重症急性胰腺炎（SAP）患者的预后与器官功能障碍之间的关系进行了研究。共有39例（54.2%）患者出现器官功能障碍，20例（27.8%）患者出现多器官功能障碍（MOD），19例（26.4%）患者出现单一器官或系统功能障碍。死亡患者的MOD发生率高于存活患者（88.2%对9.1%，p<0.01）。在多因素逻辑回归分析中，死亡的主要预测因素是肺功能衰竭和神经功能障碍。肺功能衰竭是单一器官功能障碍（57.9%）和MOD（95.0%）中最常见的器官功能障碍，总发病率为41.7%。孤立性肺功能障碍的死亡率较低，而MOD的死亡率较高（18.2%对78.9%，p<0.01）。在46例无菌性胰腺坏死患者中，有10例因不规范的专科强化治疗方案导致了不必要的手术干预。器官功能障碍会使SAP患者的预后恶化。选择针对伴有MOD的SAP的最佳治疗策略至关重要。
