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Acute hemorrhagic necrotizing pancreatitis analysis


Prognosis of patients with surgical findings 1O, simple pancreatic necrosis in 1 case, the incidence of 909%. APACHE Ⅱ score 13 points, did not occur MODS, survival; pancreatic body, tail of pancreas necrosis in 6 patients, the incidence of 5455%, average 18.33 APACHEII score points, including 1 case complicated with MODS death, mortality rate 16.67%; total pancreatectomy necrosis in 3 cases,[link widoczny dla zalogowanych], the occurrence rate of 27.27%, the average APAC ah Ⅱ score 27.00 points, including 1 case complicated with MODS, died of Internal Intensive Medicine Volume 6, Table 2, younger brother of a site of infection and bacterial infection in sick culture Results 2 patients died, mortality was 66.67%. Icu jP discussion is one of common serious diseases, patients are often very critical condition, complicated by other multi-organ dysfunction. According to the literature, the mortality rate of 20% to 50%, the cure rate was 72%, non-surgical survival rate of 83.6%, surgical survival rate 69.0% L3J. This article in 11 patients,[link widoczny dla zalogowanych], 3 deaths, mortality rate 2727%. 72.73% cure rate, survival rate was 10 cases of surgical patients 7O%, similar to those reported in literature. AHNP full course of three phases l4J: the first stage, a period of acute reaction after the onset of the early stages of Sheng, about 10 days in 11 patients who were in the acute response of the ICU. The main complications of shock,[link widoczny dla zalogowanych], renal failure, ARDS, and encephalopathy, which cause of death for early ARDS l4J 3 cases of death in this article are in the 5 ~ 7d after onset of death, 3 cases were complicated with ARDS and cardiac dysfunction . 11 100% mortality in patients with ARDS,[link widoczny dla zalogowanych], heart failure and shock mortality were 66.67%, acute renal failure fatality rate was 50% (Table 1), the mortality of these complications are high. S = stage continued for about two months of systemic infection, the source of infection has both endogenous and exogenous. The former is caused by translocation of intestinal flora, it is to take effective measures to prevent the intestinal bacterial microflora disturbance, maintenance of intestinal barrier function, prevention and treatment of secondary infection of the important principles AHNP J. Exogenous infection from the surgery, peritoneal lavage, deep venous catheter. This 11 patients there were 10 cases of infection, infection rate was 9O. 91%,[link widoczny dla zalogowanych], significantly higher than the incidence of other complications (P <0. A pair), mortality 30% (Table 1). Cases clearly exist in the site of infection abdominal infections, and 1 with the subclavian venous catheter and pulmonary infection (Table 2), infection due to endogenous and exogenous are. Example 3 and Example 7 are all pathogens detected in Thailand can be sensitive to the use of imipenem, the infection have been effectively controlled. This suggests that serious infection-prone acute hemorrhagic necrotizing pancreatitis in the specific pathogen test results obtained before the advance can prevent infection with Thailand. The third stage, residual infection in the pathogenesis of 2 to 3 months, due to poor drainage have residual retroperitoneal cavity, is often associated with pancreatic / intestinal fistula. The group had 1 patient in 2 months after the onset of pancreatic fistula, the better anti-infection: 1 case and another 2 months after the onset of left subphrenic, intestinal asked effusion, pus to be clear, anti-infective improved after treatment in patients with MODS is the major cause of death HNP, this 4 patients MODS, and 3 patients died of fatal MODS. Must be given in early stage disease should take effective measures. Prevention and treatment of pancreatic necrosis MODs0 site is associated with the outcome. With the expansion of necrotic area, the proportion of concurrent MoDS and mortality also increased. Therefore, for a large range of pancreatic necrosis, pancreatic necrosis in particular all patients, should be early detection and timely emergency treatment to reduce the incidence of complications and improve survival. Reference Man cut 1WilsonC, IlTll'it2CW, (h has rDC.Fatedacutepancreatitis (Jut.198829 (6): 7822 Qiu, the main entropy + surgery 4th edition People's Health Publishing House ,1997573-5743McFaddenDW .0 rg hoe failureandmultlp [eorgansystemfailurein9emcreatitJsPancreas, 1991 .6 (Supp 【1): $ 374 juveniles Saint, Zhang Chen Lie, two cans of pancreatic progenitor acute Lo brother deceive Mankui social evolution and treatment of cancer, Gan Cheng Mino Journal of Surgery, l993, 35 (3): 1565 is the Cheng Tong, G rule set, Xiong Dexin, brother of the pancreas such as acute Ping more cut-off when the ecosystem changed bowel tract bacterial infection and pancreatic deceive Experimental Research lazy race to save critical care medicine in China, 1997.9 (7)} 403. (1998, 2000, a draft animal husbandry l0o6 .03.04 Revised)