摘要

急性胰腺炎专科病房收治的279例患者中，210例直接入院，69例转移治疗局部或全身并发症。根据死亡率和发病率以及与病因学、预测的疾病严重程度(改良格拉斯哥评分)、器官衰竭(改良Goris多器官衰竭评分)和手术干预的需要来评估结局。直接入院的患者死亡率为1.9%，而从其他单位转移的患者死亡率为18.8%。胆结石相关胰腺炎的死亡率为3%，原因不明的胰腺炎的死亡率为15% (p = 0.03)，内镜后逆行胰胆管造影胰腺炎的死亡率为27% (p = 0.01)。死亡率与年龄有关(55岁死亡率> 11% vs 2%;p = 0.003)和Goris评分(评分0，死亡率0% v评分5-9，死亡率67%;P = 0.001)。在从其他单位转院的患者中，确诊后一周内转院的患者死亡率为11%，延迟转院的患者死亡率为35% (p = 0.04)。36例患者经动态计算机断层扫描发现胰腺坏死，其中29例患者行胰腺坏死切除术，死亡率34%。死亡率与改良Goris评分相关(幸存者中位数评分2 vs非幸存者中位数评分6; p = 0.005) and was higher when necrosectomy was performed within the first two weeks of admission (100% vs 21%; p = 0.004). In conclusion, mortality in acute pancreatitis is influenced by age, aetiology of the disease, and presence of organ failure. Patients transferred for specialist care have a 10-fold greater mortality than those admitted directly and mortality is greatest when transfer is delayed. Early necrosectomy carries a prohibitively high mortality.