Clinical analysis of ARDS induced by severely acute pancreatitis 
                                             Abstract

Objective To study the clinical features and treatment of acute respiratory distress syndrome (ARDS) secondary to severe acute pancreatitis (SAP).

Methods A total of 67 patients diagnosed with SAP were enrolled in the study；patients were monitored for study arterial blood gas and chest-X- ray were examined within 24 hours after SAP.

Results 23 patients among 67 patients of SAP developed ARDS (34.33%). The percentage of patients who developed ARDS with PaO2＜60mmHg was above 60%.While the percentage of patients who developed ARDS with PaO2＜32mmHg was about 90%. 50% of SAP patients appeared lung abnormalities by X-ray examination.

Conclusion The respiratory function of SAP patients should be carefully observed so that we could find the development of ARDS in early stage.
【Key words】 severe acute pancreatitis;acute respiratory distress syndrome(ARDS)
         重症急性胰腺炎（SAP）发病急骤、变化迅速、病情危重而复杂，预后不佳，病死率较高。急性呼吸窘迫综合征（ARDS）是SAP的重要并发症之一，其临床表现为低氧和呼吸困难。是发生多器官衰竭（MOF）和患者死亡的重要原因。本研究旨在对SAP并发ARDS进行临床特点的分析，并讨论其治疗体会。
1 资料与方法
1.1 一般资料 2000年1月～2005年12月我院消化科收治SAP患者67例，其中男37例，女30例；年龄32～70岁，平均50.42±14.79岁；SAP诊断符合中华医学会外科学会胰腺学组制订的急性胰腺炎临床诊断及分级标准［1］，其中并发ARDS 23例，男16例，女7例；年龄32～67岁。ARDS诊断符合中华医学会呼吸病学分会制订的ARDS诊断标准［2］。
1.2 SAP并发ARDS的识别 对SAP患者严密观察生命体征，检测血、尿淀粉酶、外周血白细胞计数、血糖、电解质等。发病24ｈ之内监测动脉血气和胸部X线片的早期变化，以便早期识别SAP并发的ARDS。
1.3 治疗方法 SAP确诊后全部实行保守治疗，包括禁食，胃肠减压，纠正水、电解质及酸碱平衡紊乱，促进肠蠕动，应用能透过血-胰屏障的抗生素，生长抑素（施他宁）抑制胰腺分泌，全胃肠外营养（TPN）或肠内营养（EN）支持。23例并发ARDS患者在治疗原发病的同时，行经鼻或口气管插管给氧。