摘要
目的 研究重症急性胰腺炎(SAP)合并胰性脑病(PE)的临床表现特点。方法 回顾性分析我院近期收治的SAP病例2 2 5例,其中3 8例合并PE(称PE组) ,187例不合并PE(称非PE组) ,比较两组的临床特点。结果 PE组出现T≥3 8 . 5℃、低氧血症、白细胞计数≥16×10 9/L及MODS的百分率均明显高于非PE组(P <0 . 0 5 ) ;PE组发病72h内最高血淀粉酶明显高于非PE组(P <0 . 0 5 )。PE组2 1例(5 5 . 2 6%)病人于发病2周内并发神经精神症状,18例(4 7. 3 7%)病人表现为兴奋型,3 2例(84 . 2 1%)病人脑电图表现为轻～中度广泛性慢波,同步性θ及δ波,2 9例(76 . 3 2 %)病人头部CT或MRI检查发现脑室水肿和脱髓鞘改变。结论 PE具有全身炎症反应重、血淀粉酶水平高,MODS发生率高,病死率高的特点。约半数PE患者于发病后2周内并发PE且表现为兴奋型,多数病人脑电图表现为轻～中度广泛性慢波,同步性θ及δ波,头部CT或MRI检查发现脑室水肿和脱髓鞘改变。
Objective To study the clinical characteristics of severe acute pancreatitis(SAP)complicated by pancreatic encephalopathy(PE).Methods Data of 225 patients with severe acute pancreatitis(SAP) admitted to our hospital within 72h after onset of symptoms from Jan 2000 to Mar 2003 were reviewed.38 patients had PE,and 187 patients had no PE.The clinical characteristics between PE group and non-PE group were compared.Results The incidences of T≥38.5℃,hypoxemia,white cell count≥16×10 9/L and MODS in PE group were higher than those in non-PE group(P<0 05).The highest blood amylase in PE group were higher than that in non-PE group(P<0 05).In PE group,21(55.26%)patients had nervous-psychotic episode within 2 weeks after onset of symptoms,18(47.37%)patients were exciting type,32(84.21%)patients had mild or middle slow waves and synchronous θ and δ waves in electroencephalogram(EEG),29(76.32%) patients had ventricle edema and demyelination in CT or MRI examination.Conclusion PE is characterised by SIRS,high blood amylase,high incidence of MODS and high mortality.About one half patients with PE had nervous-psychotic episode within 2 weeks and were exciting type.There were mild or middle waves and synchronous θ and δ waves in EEG and ventricle edema and demyelination in CT or MRI examination in most cases.
出处
《四川医学》
CAS
2005年第4期381-383,共3页
Sichuan Medical Journal
关键词
胰性脑病
临床特点
病死率
pancreatic encephalopathy,clinical characteristics,mortality
