复发性胆源性胰腺炎的临床特点及诱发因素分析

吕坤; 陈翔

doi:10.3969/j.issn.1001-5256.2016.01.024

复发性胆源性胰腺炎的临床特点及诱发因素分析

DOI: 10.3969/j.issn.1001-5256.2016.01.024

吕坤,
陈翔

1. 重庆市红十字会医院江北区人民医院普外科
2. 重庆市第四人民医院肝胆外科

详细信息

中图分类号: R576
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出版历程
- 收稿日期: 2015-05-14
- 出版日期: 2016-01-20

Clinical features of recurrent biliary pancreatitis and its predisposing factors

Lu: Kun,
Chen Xiang

Department of General Surgery,Chongqing Red Cross Hospital ( Jiangbei District People' s Hospital)

摘要

摘要: 目的探讨复发性胆源性胰腺炎的临床特点及诱发因素。方法选取江北区人民医院2008年1月-2014年12月收治的272例胆源性胰腺炎患者,其中复发性胆源性胰腺炎56例（复发组）,初发性胆源性胰腺炎216例（初发组）。比较2组患者的临床特点和诱因。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果 2组患者的年龄、病死率比较,差异均无统计学意义（P值均>0.05）。与初发组比较,复发组中男性所占比例、APACHE-Ⅱ评分、中重度胰腺炎、胆总管结石发生率、合并胆总管开口狭窄率、合并高脂血症率、手术治疗率均显著升高（P值均<0.05）。复发组复发2次者与复发2次以上者的胰腺炎分型比较,差异亦有统计学意义（P=0.040）。复发组有明确诱因者明显高于初发组（80.36%vs 58.33%,P=0.002）。复发组中高脂饮食、饮酒率明显高于初发组（P值均<0.05）,但是2组胆道感染、口服药物率的差异无统计学意义（P值均>0.05）。结论复发性胰腺炎在男性中多见,相对较重,常合并胆总管结石、胆总管开口狭窄、高脂血症,手术治疗率高。高脂饮食和饮酒是复发性胆源性胰腺炎...
- 胰腺炎 /
- 复发 /
- 危险因素
Abstract: Objective To investigate the clinical features of recurrent biliary pancreatitis and related predisposing factors. Methods A total of 272 patients with biliary pancreatitis who were admitted and treated in Jiangbei District People's Hospital from January 2008 to December 2014 were enrolled and divided into recurrence group( 56 patients with recurrent biliary pancreatitis) and primary group( 216 patients with primary biliary pancreatitis). Clinical features and predisposing factors were compared between the two groups. Comparison of continuous data between the two groups was made by t test and comparison of categorical date was made by chi- square test. Results There were no significant differences in age and mortality between the two groups( both P > 0. 05). Compared with the primary group,the recurrence group had a significantly higher proportion of males,a significantly increased APACHE- Ⅱ score,significantly increased incidence rates of moderate- to- severe pancreatitis and common bile duct stones,significantly higher rates of stenosis of the common bile duct orifice and hyperlipidemia,and a significantly higher rate of surgical treatment( all P < 0. 05). In the recurrence group,the type of pancreatitis differed significantly between patients with 2 times of recurrence and those with > 2 times of recurrence( recurrence for more than 2 times)( P =0. 040). Compared with the primary group,the recurrence group had a significantly higher proportion of patients with known predisposing factors( 80. 36% vs 58. 33%,P = 0. 002),as well as significantly higher rates of high- fat diet and drinking( both P < 0. 05). However,the rates of biliary tract infection and oral administration of drugs showed no significant differences between the two groups( both P > 0. 05).Conclusion Recurrent biliary pancreatitis is common and severe in males,and is often complicated by common bile duct stones,stenosis of the common bile duct orifice,and hyperlipidemia,with a high rate of surgical treatment. High- fat diet and drinking are important predisposing factors for recurrent biliary pancreatitis.
- pancreatitis /
- recurrence /
- risk factors

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参考文献(12)

[1]ZHAO YP.Diagnostic criteria and treatment principles for biliary pancreatitis[J].Chin J Hepatobiliary Surg,2002,8(2):95-96.(in Chinese)赵玉沛.胆源性胰腺炎诊断标准与处理原则的探讨[J].中华肝胆外科杂志,2002,8(2):95-96.

[2]Pancreas Study Group,Chinese Society of Gastroenterology,Chinese Medical Association,Editorial Board of Chinese Journal of Pancreatology,Editorial Board of Chinese Journal of Digestion.Chinese guidelines for the management of acute pancreatitis(Shanghai,2013)[J].J Clin Hepatol,2013,29(9):656-660.(in Chinese)中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2013年,上海)[J].临床肝胆病杂志,2013,29(9):656-660.

[3]WANG FH.Research advances in minimally invasive treatment of acute biliary pancreatitis[J].Clin J Curr Adv Gen Surg,2013,16(1):76-78.(in Chinese)王方华.急性胆源性胰腺炎的微创治疗进展[J].中国现代普通外科进展,2013,16(1):76-78.

[4]CHEN YX.Diagnosis and treatment of biliary pancreatitis[J].Chin J Pract Intern Med,2014,34(9):843-846.(in Chinese)陈幼祥.急性胆源性胰腺炎的诊断和治疗[J].中国实用内科杂志,2014,34(9):843-846.

[5]Chinese College of Emergency Physicians.Chinese clinical practice guidelines for emergency treatment of acute pancreatitis(2013)[J].Chin J Crit Care Med,2013,33(12):1057-1071.(in Chinese)中国医师协会急诊医师分会.2013中国急诊急性胰腺炎临床实践指南[J].中国急救医学,2013,33(12):1057-1071.

[6]LIU SP.Etiology of recurrent acute pancreatitis and its endoscopic therapy progress[J].Med Recapitulate,2012,18(2):247-250.(in Chinese)刘世萍.复发性急性胰腺炎的病因及内镜治疗进展[J].医学综述,2012,18(2):247-250.

[7]QIAO H,HE SJ.Recurrent biliary pancreatitis:a clinical analysis of 87 cases[J].Chongqing Med,2003,32(6):740-741.(in Chinese)乔华,何世举.胆源性复发性胰腺炎87例的临床分析[J].重庆医学,2003,32(6):740-741.

[8]QIU WG,XU J.Analysis of risk factors for postoperative recurrence of gallbladder stones with common bile duct stones[J].Chin J Gen Surg,2014,23(2):170-173.(in Chinese)裘文刚,徐江.胆囊结石合并胆总管结石术后复发的危险因素分析[J].中国普通外科杂志,2014,23(2):170-173.

[9]MA HY,ZHENG YM,LI F.Research advances in hyperlipidemic pancreatitis[J].Chin J Hepatobiliary Surg,2014,20(12):909-912.(in Chinese)马海云,郑亚民,李非.高脂血症性胰腺炎研究进展[J].中华肝胆外科杂志,2014,20(12):909-912.

[10]ZHANG J.Related risk factors influencing the recurrence of common bile duct stones after surgery[J].Anhui Med Pharm J,2013,17(10):1733-1734.(in Chinese)张军.影响胆总管结石术后复发的相关危险因素研究[J].安徽医药,2013,17(10):1733-1734.

[11]PATMAN G.Pancreatitis:mislocalization of CFTR by alcohol promotes pancreatitis[J].Nat Rev Gastroenterol Hepatol,2015,12(1):2.

[12]CRIDDLE DN.The role of fat and alcohol in acute pancreatitis:a dangerous liaison[J].Pancreatology,2015,15(4 Suppl):s6-s12.

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