急性重症胰腺炎合并胰性脑病的临床诊治

摘要

目的 通过重症胰腺炎合并胰性脑病的临床表现和治疗观察,总结诊断和治疗经验.方法 对治疗的72例急性重症胰腺炎(SAP)回顾调查,了解SAP并发胰性脑病(PE)的发生、发病机制及诊断和治疗情况对SAP预后的影响.结果 72例SAP,9例并发PE(12.5％),多在起病3～15天开始呈多样性神经精神症状,发病机理尚不清楚,其中胆原性4例,酒精性2例.死亡3例(33.3％),9例均有胰腺坏死的CT表现.结论 PE易误诊,死亡率高,胰腺炎基础疾病治疗是关键,营养支持治疗和神经精神症状对症治疗也很重要.%Objective To research the clinical manifestations and treatment of pancreatic encephalopathy in severe pancreatitis. Method Clinical data of 72 cases of severe acute pancreatitis were analyzed with the investigation and understanding of SAP complicated with pancreatic encephalopathy (PE), pathogenesis, diagnosis and treatment on the prognosis. Results Among 72 patients with SAP, there were 9 cases with PE (12. 5%), including four cases of biliary and alcoholic patients. 3 cases died (33. 3%). 9 patients had CT findings of pancreatic necrosis. Conclusion There was high mortality of PE. The key of treatment of PE is basic diseases treatment, and nutritional support and neuropsychiat-ric symptoms treatment are also important.