复发性急性胰腺炎的病因及治疗方案的选择

曹钰; 凌俊; 张勇; 丁兵; 蒋辉

doi:10.3969/j.issn.1001-5256.2017.12.018

复发性急性胰腺炎的病因及治疗方案的选择

DOI: 10.3969/j.issn.1001-5256.2017.12.018

1. 西南医科大学临床医学院
2. 内江市第二人民医院肝胆胰外科

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中图分类号: R576
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出版历程
- 收稿日期: 2017-06-06
- 出版日期: 2017-12-20

Recurrent acute pancreatitis:etiology and selection of treatment regimen

Department of Clinical Medicine, Southwest Medical University

摘要

摘要: 目的探讨复发性急性胰腺炎（RAP）的病因及治疗方案的选择。方法回顾性分析内江市第二人民医院2012年1月-2015年12月收治的284例急性胰腺炎（AP）患者,其中初发性急性胰腺炎患者232例（初发组）,RAP患者52例（复发组）。收集2组患者的一般情况、病因、复发次数、复发间隔时间、治疗方案及转归情况。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。结果复发组胆源性因素、高脂血症因素高于初发组（66.8%vs 35.8%,χ2=7.109,P=0.008;17.3%vs 16.0%,χ2=5.818,P=0.007）,而饮食因素复发组要低于初发组（7.7%vs 21.1%,χ2=5.046,P=0.025）。复发组52例患者中,复发1次33例（63.46%）、复发2次14例（26.92%）、复发3次及以上5例（9.62%）;距初次发病间隔6个月内12例（23.08%）,间隔612个月内23例（44.23%）,间隔12个月及以上17例（32.69%）。RAP组52例患者中23例行手术治疗、23例行保守治疗、6例行内镜治疗,随访观察62
- 胰腺炎 /
- 复发 /
- 治疗
Abstract: Objective To investigate the etiology of recurrent acute pancreatitis ( RAP) and selection of treatment regimen. Methods A retrospective analysis was performed for the clinical data of 284 patients with acute pancreatitis ( AP) who were admitted to The Second People's Hospital of Neijiang from January 2012 to December 2015, and among these patients, 232 had incipient AP ( incipient group) and 52 had RAP ( recurrent group) . The two groups were analyzed in terms of general status, etiology, number of times of recurrence, recurrence interval, treatment regimen, and prognosis. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the incipient group, the recurrent group had a significantly higher proportion of patients with biliary factors ( 66. 8% vs 35. 8%, χ2= 7. 109, P = 0. 008) or hyperlipidemia ( 17. 3% vs16. 0%, χ2= 5. 818, P = 0. 007) , as well as a significantly lower proportion of patients with diet factors ( 7. 7% vs 21. 1%, χ2= 5. 046, P = 0. 025) . Among the 52 patients in the recurrent group, 33 ( 63. 46%) had one time of recurrence, 14 ( 26. 92%) had two times of recurrence, and 5 ( 9. 62%) had three or more times of recurrence; as for recurrence interval, 12 ( 23. 08%) had a recurrence interval of less than 6 months, 23 ( 44. 23%) had a recurrence interval of 6-12 months, and 17 ( 32. 69%) had a recurrence interval of more than 12 months; as for the selection of treatment regimen, 23 underwent surgical treatment, 23 underwent conservative treatment, and 6 underwent endoscopic therapy. These patients were followed up for 6-24 months, and no patient died or experienced recurrence. Conclusion RAP has a complex etiology, and biliary factors and hyperlipidemia are closely associated with the recurrence of AP. Identification of etiology and active etiological treatment can effectively reduce the recurrence rate of AP.
- pancreatitis /
- recurrence /
- therapy

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参考文献(15)

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