论文部分内容阅读
据大样本统计,急性胰腺炎(下称AP)的平均死亡率14.2％。在134例AP死因统计中,单一脏器损害者仅36.6％,死于呼吸衰竭者为10％。胰腺疾病的肺部合并症,与胰腺病情轻重无关,甚至可出现于病变的恢复期。一、AP的肺部合并症:1.早期潜隐性缺氧(EOH)或临床早期缺氧损伤、急性胰腺炎初期潜隐性低氧血症发病率较高,Ranson等报告85例AP患者在发病48小时内,70％患者PaO_2低于76mmHg,而胸部X线检查阳性者仅11％。(足赤)见等报告132例AP患者56％PaO_2降低,X线阳性仅19％。EOH多在AP发病48小时内出现,此时临床症状很轻,仅有脉速、呼吸加快,而无明显的呼吸困难。如有过度换气,可引起PaCO_2降低。 EOH的病因不明,与年龄、血中淀粉酶值、血钙值等无关。初次发病比复发者多见,经过治疗多于1周内消退。如未及时处理,可引起心、肺衰竭而死亡。
According to a large sample statistics, the average mortality rate of acute pancreatitis (hereinafter referred to as AP) 14.2%. Among the 134 AP death causes, only 36.6% were single organ damage and 10% died of respiratory failure. Pulmonary complications of pancreatic disease, pancreatic disease severity has nothing to do, and even in the recovery of the disease. First, AP’s pulmonary complications: 1. Early latent hypoxia (EOH) or early clinical hypoxic injury, the early onset of acute pancreatitis has a high incidence of hypoxemia, Ranson reported 85 cases of AP patients PaO 2 was below 76 mmHg in 70% of patients within 48 hours of onset, compared to 11% of those with positive chest X-rays. (Adequate) See other reports of 132 cases of AP patients 56% PaO_2 decreased, X-ray positive only 19%. EOH more in AP onset within 48 hours, then the clinical symptoms are very light, only the pulse rate, breathing speed, without obvious breathing difficulties. If hyperventilation, can cause PaCO_2 reduction. EOH etiology is unknown, and age, blood amylase, serum calcium value has nothing to do. The initial incidence of more common than recurrence, after treatment more than 1 week subsided. If not handled in time, can cause heart and lung failure and death.