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1、急性重症胰腺炎临床表现及预后的影响因素河南省郑州市人民医院急诊科450000摘要:目的总结急性重症胰腺炎的临床特征,分析影响患者预后的高危因素。方法回顾性分析2012年3月・2014年3月我院收治的82例急性重症胰腺炎患者的临床资料,分析急性重症胰腺炎的临床特征表现,总结高危影响因素。结果生存组平均年龄为(49.6±14.8)岁,明显低于死亡组(P<0.05),住院时间为(84.3±65.2)d,长于死亡组,APACHEII评分为(6.2±3.4)分,同样低于死亡组(PV
2、0.05);生存组平均年龄为(49.6±14.8)岁,明显低于死亡组(P<0.05),住院时间为(84.3±65.2)d,长于死亡组,APACHEII评分为(6.2±3.4)分,同样低于死亡组(P<0.05);死亡组衰竭部位多为肺、肾、心血管系统与血液系统,且口例患者均合并多脏器官心力衰竭,占91.7%,明显高于生存组(P<0.05);肺脏衰竭、心血管系统衰竭、肾脏衰竭均为影响急性重症胰腺炎患者预后的主要因素。结论急性重症胰腺炎死亡病例临床特征表现为高龄、多器官及系统衰竭
3、,且患者入院后APACHEII评分较高,且心血管系统衰渴、肺脏衰渴及肾脏衰渴是影响急性重症胰腺炎患者预后水平的相关危险因素。关键词:重症胰腺炎;临床特点;预后;高危因素Abstract:ObjectiveTosummarizetheclinicalcharacteristicsofsevereacutepancreatitis,analyzedriskfactorswhichimpacttheprognosisofthepatients.MethodsRetrospectiveanalysisof82caseso
4、fsevereacutepancreatitispatients’clinicaldatainMarch2012-March2014inourhospital,analysisofclinicalfeaturesofsevereacutepancreatitis,summarizedhigh-riskfactors.ResultsThemeanageofsurvivalgroup(49.6±14・8),wassignificantlowerthanthatofdeathgroup(P&I
5、t;0.05),lengthofhospitalstaywas(84.3±65.2)d,Iongerthanthegroupofdeath,APACHEIIscore(6.2±3・4),thesamebelowthedeathgroup(P<0.05);meanage(survivalgroup49.6±14.8),wassignificantlowerthanthatofdeathgroup(P<0.05),lengthofhospitalstaywas(8
6、4.3±65.2)d,longerthanthegroupofdeath,APACHEIIscore(6.2±3.4),thesamebelowthedeathgroup(P<0.05);failuresiteforthelung,kidney,cardiovascularsystemandthebloodsystemindeathgroup,11patientswerecomplicatedwithmultiplevisceralorganfailure,accountingf
7、or91.7%,wassigrdficanthigherthansurvivalgroup(P<0.05);lungfailure,cardiovascularsystemfailure,kidneyfailurewerethemainfactorsinfluencingtheprognosisofsevereacutepancreatitispatients.ConclusionTheclinicalfeaturesofsevereacutepancreatitisdeathcasesshowedadva
8、needage,multipleorganandsystemfailure,andpatientsafteradmissionAPACHEscoreishigh,andthecardiovascularsystemfailure,respiratoryfailureandrenalfailureisrelatedtoprognosisinfluencerisklevelo