本文選題：急性胰腺炎 + 急性肺損傷��； 參考：《中南大學(xué)》2013年碩士論文

【摘要】：目的：描述和分析2008年1月1日至2012年12月31日期間急性胰腺炎患者的一般資料、病因、臨床特點,分析急性胰腺炎急性肺損傷并發(fā)癥的影響因素,為進(jìn)一步提高急性胰腺炎的診治水平,提高治療療效,降低病死率,提供可靠的、科學(xué)的的依據(jù)。 方法：收集2008年1月1日至2012年12月31日期間在湖南省人民醫(yī)院住院治療的內(nèi)科和外科的資料完整有效急性胰腺炎病例共432例。采用回歸性分析,對急性胰腺炎的不同人群特征和急性肺損傷并發(fā)癥相關(guān)影響因素進(jìn)行統(tǒng)計分析。 結(jié)果： 1.在本次收集的432例急性胰腺炎病例中,男性236例,占54.6%；女性病例196例,占45.4%；平均年齡47.7±16.4歲,急性胰腺炎的好發(fā)年齡集中在30-70歲；文化程度以高中／大專為主,占55.1%；職業(yè)以農(nóng)民和公務(wù)員占大多數(shù),農(nóng)民112例,占25.9%；公務(wù)員48例,占20.5%。經(jīng)濟(jì)狀況為一般的占大多數(shù),達(dá)78.7%；醫(yī)療保健花費以社會醫(yī)療保險為主,占31.0%。男性吸煙者84例,占35.6%；女性吸煙者39例,占18.4%。男性飲酒者152例,占64.4%；女性飲酒者64例,占18.4%。伴隨疾病中最常見的是高血壓、脂肪肝、糖尿病,分別占24.1%、17.6%、15.7%。 2.輕型急性胰腺炎有296例,占68.5%,重型急性胰腺炎有136例,占31.5%。 3.發(fā)病原因中的主要病因是膽源性疾病、高脂血癥性、酒精性、暴飲暴食性,分別占34.3%、14.6%、13.2%、10.2%,其他的病因還有外傷、手術(shù)、ERCP等其他原因。 4.臨床癥狀主要是腹痛、發(fā)熱、惡心、嘔吐、腹脹、黃疸,分別達(dá)到了100.0%、72.2%、68.5%、63.4%、58.3%、30.6%。體征主要是腹部壓痛、腸鳴音減弱、肌緊張、腹部反跳痛,分別達(dá)到了79.6%、38.9%、32.4%和28.7%。 5.B超診斷的陽性率為75.0%,經(jīng)CT診斷的陽性率為96.3%,CT診斷急性胰腺炎的陽性率高于B超。 6.432例急性胰腺炎中發(fā)生急性肺損傷共39例,占9.03%。 7.疾病分型和入院時的乳酸脫氫酶、尿素氮、白細(xì)胞和動脈血氧分壓是重癥急性胰腺炎發(fā)生急性肺損傷的影響因素。 結(jié)論： 1.該院432例急性胰腺炎患者中急性肺損傷并發(fā)癥的發(fā)生率為9.03%。 2.重型急性胰腺炎和入院時的乳酸脫氫酶異常、尿素氮異常、白細(xì)胞異常、動脈血氧分壓異常是急性胰腺炎并發(fā)急性肺損傷的危險因素。
[Abstract]:Objective: to describe and analyze the general data, etiology and clinical characteristics of patients with acute pancreatitis from January 1, 2008 to December 31, 2012, and to analyze the influencing factors of complications of acute lung injury in acute pancreatitis. In order to further improve the level of diagnosis and treatment of acute pancreatitis, improve the therapeutic efficacy, reduce the mortality, provide a reliable, scientific basis. Methods: 432 cases of complete and effective acute pancreatitis were collected from January 1, 2008 to December 31, 2012, which were hospitalized in Hunan Provincial people's Hospital. Regression analysis was used to analyze the different population characteristics of acute pancreatitis and the related factors of acute lung injury complications. Results: 1. Among the 432 acute pancreatitis cases collected, 236 cases were male (54.6%), 196 cases were female (45.4%), the average age was 47.7 鹵16.4 years, the predilection age of acute pancreatitis was 30-70 years old. Peasants and civil servants accounted for the majority of the occupation, 112 for peasants, 25.9 for peasants, and 48 for civil servants, accounting for 20.5 percent. The average economic status was 78.7%, and the health care expenditure was mainly social medical insurance, accounting for 31.0%. There were 84 male smokers (35. 6%) and 39 female smokers (18. 4%). 152 cases (64.4%) were male drinkers and 64 cases (18.4%) were female drinkers. The most common concomitant diseases are hypertension, fatty liver and diabetes, accounting for 24.1and 17.6g / 15.7 respectively. 2. There were 296 cases of mild acute pancreatitis (68.5%) and 136 cases of severe acute pancreatitis (31.5%). 3. The main causes of the disease were biliary diseases, hyperlipidemia, alcoholism, and overeating, respectively, accounting for 34.30.14.6% and 13.2g / 10.2 respectively. The other causes were trauma, surgical ERCP and other causes. 4. The main clinical symptoms were abdominal pain, fever, nausea, vomiting, abdominal distension and jaundice, which reached 100.0, respectively. The main signs were abdominal tenderness, weakened bowel sounds, muscle tension, abdominal rebound pain, which reached 79.6% 38.9% and 28.7%, respectively. 5.The positive rate of B-ultrasonography was 75.0 and that of CT was 96.3and the positive rate of CT was higher than that of B-ultrasound. Acute lung injury occurred in 39 cases (9.03%) in 6.432 cases of acute pancreatitis. 7. Classification and admission of lactate dehydrogenase, urea nitrogen, white blood cell and arterial partial pressure of oxygen were the influencing factors of acute lung injury in severe acute pancreatitis. Conclusion: 1. The incidence of complications of acute lung injury in 432 patients with acute pancreatitis was 9.03. 2. Abnormal lactate dehydrogenase, abnormal urea nitrogen, abnormal white blood cell and abnormal arterial partial pressure of oxygen are the risk factors of acute pancreatitis complicated with acute lung injury.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R576;R563.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周秀云;李青松;任全剛;;急性胰腺炎的超聲診斷[J];中國超聲診斷雜志;2006年06期

2 謝俊鋒;徐萍;;急性胰腺炎相關(guān)性肺損傷發(fā)病機(jī)制研究進(jìn)展[J];國際消化病雜志;2008年06期

3 吳玉純,許吟秋,孫貴海,鄭一丘;螺旋CT動態(tài)掃描對胰腺癌的早期診斷[J];哈爾濱醫(yī)藥;2004年02期

4 黃麗彬,唐承薇,謝詠梅,黃茂濤,李良平,趙聰,史維,岳光平;成都地區(qū)3073例急性胰腺炎致病危險因素分析[J];四川大學(xué)學(xué)報(醫(yī)學(xué)版);2005年01期

5 姚瑋艷,袁耀宗;急性胰腺炎發(fā)病機(jī)制的新進(jìn)展[J];現(xiàn)代實用醫(yī)學(xué);2005年09期

6 孫耀輝;付克廣;藤錄俠;華瑞;任法云;葛煒;王磊;李凡良;陳淑華;;急性胰腺炎的螺旋CT診斷(附62例分析)[J];實用放射學(xué)雜志;2007年01期

7 李全;魯廣華;許林;章東映;;螺旋CT與MRI對急性胰腺炎的診斷價值比較分析[J];醫(yī)學(xué)影像學(xué)雜志;2007年03期

8 李震東;馬清涌;羅羽宏;;Fas/FasL介導(dǎo)的caspase-3活化與急性胰腺炎腺泡細(xì)胞凋亡的關(guān)系[J];中國病理生理雜志;2009年06期

9 唐詩彬;張肇達(dá);吳路楊;廖裕彬;;急性壞死性胰腺炎大鼠白細(xì)胞L-選擇素表達(dá)和肌動蛋白分布的變化及中藥華西胰腺炎一號的影響[J];中國病理生理雜志;2009年07期

10 林旭紅;李永渝;;急性胰腺炎發(fā)病機(jī)制及相關(guān)治療的研究進(jìn)展[J];中國病理生理雜志;2010年05期

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