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急性胰腺炎并发胸水13例(64％),其中胆源性胰腺炎6例(46％),酒精性胰腺炎3例(23％),暴食1例,高胆红素血症1例,不明原因1例,腹部外伤史1例。单有胰性胸水3例(23％),并存于胰性腹水10例(76.9％),其中血性胸水2例。6例大量胸水伴气急,1例发生ARDS,1例MOF。胸水中淀粉酶均在2056u/L～130000u/L,胸水蛋白12例36～51g/L,1例30g/L(原有低蛋白血症)。胸水细菌培养1例肺炎球菌生长(可能并发肺部感染),12例(3次)均阴性,胸水癌细胞及抗酸杆菌检查(3次)均阴性。13例住院过程中,以抗胰酶、制酸及支持等疗法,大量胸水者抽水1～2次,结果内科治愈9例,1例手术治疗。死亡3例,2例分别死于ARDS和MOF,1例慢性酒精性胰腺炎,大量胸腹水,放腹水18次,抽胸水3次,输血6400ml,输血浆2000ml,补充白蛋白400 g等治疗无效,全身衰竭死亡。
Thirteen patients (64%) had acute pancreatitis complicated with pleural effusion, of which 6 were biliary pancreatitis (46%), 3 were alcoholic pancreatitis (23%), 1 was gluttony and 1 was hyperbilirubinemia. One case, one case of abdominal trauma. There were 3 cases of pancreatic pleural effusion (23%), and 10 cases (76.9%) of pancreatic ascites, including 2 cases of bloody pleural effusion. 6 cases of pleural effusion with acute, 1 case of ARDS, 1 case of MOF. Pleural fluid amylase were 2056u / L ~ 130,000u / L, pleural effusion protein 12 36 ~ 51g / L, 1 case of 30g / L (the original hypoproteinemia). Pleural effusion bacterial culture in 1 case of pneumococcal growth (possible pulmonary infection), 12 cases (3 times) were negative, pleural fluid cancer cells and acid-fast bacilli (3 times) were negative. 13 cases of hospitalization, with anti-pancreatic enzyme, acid and support therapy, a large number of hydrothorax pumping 1 or 2 times, the results of 9 cases of medical treatment, 1 case of surgical treatment. 3 died, 2 died of ARDS and MOF, 1 case of chronic alcoholic pancreatitis, pleural effusion, ascites 18 times, pleural effusion 3 times, blood transfusion 6400ml, blood transfusion 2000ml, albumin 400g and other treatment ineffective , Systemic failure death.