中国普通外科杂志2012，Vol.21Issue(9)：1051-1056,6.
重症急性胰腺炎合并麻痹性肠梗阻的临床特点及其预后
Clinical features and prognosis of severe acute pancreatitis with associated paralytic ileus
摘要
Abstract
Objective: To investigate the characteristics of paralytic ileus (PI) during the course of severe acute pancreatitis (SAP) and its influence on the prognosis.Methods: The clinical data of 45 patients with SAP admitted from February 2011 to March 2012 were reviewed. Of the patients, 19 cases were complicated with PI (SAP+PI group) and 26 cases without PI (SAP group). The clinical characteristics of SAP with associated PI and its prognosis were analyzed. Results: CT scan showed the incidence of the accumulation of gas and fluid in small intestine and colon, hugely distended bowel loop and bowel wall edema in SAP+PI group was 100%, 73.7% and 78.9% respectively, while in SAP group, the first two signs were not obvious and the incidence of bowel wall edema was 50% (P=0.048). Compared with SAP group, the gastric retention volume, incidence of feeding intolerance (FI) and jaundice, and the intra-abdominal pressure (LAP) as well as the extent of LAP change were significantly elevated in SAP+PL group (all P<0.05). In addition, the length and cost of hospitalization, and mortality rate were increased in SAP+PI group compared with SAP group (all P<0.05). Univariate analysis indicated that FI, LAP (>15 mmHg), jaundice and gastric retention volume (>250 mL/d) were important factors affecting the prognosis of SAP patients (all P<0.0S). Conclusion: The predominant signs of SAP with PI in CT images are the accumulation of gas and fluid and hugely distended bowel loop. SAP patients with associated PI are frequently complicated by intra-abdominal hypertension, jaundice, FI and gastric retention, which may contribute to the increased mortality of these patients.关键词
胰腺炎,急性坏死性/肠假性梗阻/临床特点/预后Key words
Pancreatitis, Acute Necrotizing/ Intestinal Pseudo-Obstruction/ Clinical Characteristics/ prognosis分类
医药卫生引用本文复制引用
李刚,王思珍,孙加奎,顾萍萍,童智慧,李维勤..重症急性胰腺炎合并麻痹性肠梗阻的临床特点及其预后[J].中国普通外科杂志,2012,21(9):1051-1056,6.基金项目
国家自然科学基金面上项目(81170438). （81170438）
