目的 探讨5例特重型胰腺炎的特点及治疗方法。方法 我院2001年8月至2003年8月共收治特重型胰腺炎患者5例。其中入院后18 h内心跳、呼吸骤停3次的重症急性胰腺炎（SAP）1例，治疗以及时血液滤过和心、肺、脑复苏为重点； SAP并发胰性脑病2例，以大剂量维生素B1的补充，或足量补给浓缩红细胞为治疗重点； 并发多个器官功能障碍的暴发性胰腺炎（FAP）2例，治疗重点是血液滤过和防治多器官功能衰竭的级联放大反应，其中1例以高渗性糖昏迷为主要表现，治疗重点是内稳态的纠正，血液滤过，重要器官功能维护。结果 5例特重型胰腺炎患者均治愈，平均住院时间为32.2 d。结论 器官功能的复苏和维护、外科ICU监护、短时血液滤过、内稳态的纠正、中西药综合治疗及病因、对症的个体化治疗是特重型胰腺炎的重要治疗措施。
【Abstract】ObjectiveTo study the therapeutic effects of indwelling catheters in patients with severe acute pancreatitis (SAP). MethodsThe clinical data of 113 patients with severe acute pancreatitis admitted to our hospital from Aug. 2002 to May 2004 were collected. The patients were divided into the indwelling catheter group (45 cases) and the control group (68 cases).The APACHEⅡscores and therapeutic results were compared. The drainage and intraabdominal pressure (IPA) were monitored. Results The APACHEⅡscores on day 2 and day 5 after therapy in indwelling catheter group were significantly decreased compared with the control group(P=0.000).The average hospital stay and cyst morbidity of the indwelling catheter group were significantly decreased compared with those of the control group(P=0.000). The mortality rate was lower in the indwelling catheter group, but there was no statistical difference between these two groups(Pgt;0.05). The IAP was positively correlative with the drainage volume, hospital day and APACHEⅡscores(r=0.552, r=0.748, r=0.923，P=0.000). ConclusionThe indwelling catheter is an important treatment in patients with SAP.