高脂血症性胰腺炎的临床诊治

Dignosis and treatment of hyperlipidemic pancreatitis

目的探讨高脂血症性胰腺炎的临床诊治特点。方法回顾性分析1994年7月-2005年12月我院收治的12例高脂血症性胰腺炎的临床资料。除按急性胰腺炎的一般处理外,另予以降脂治疗、慎用脂肪乳剂、降低血液粘滞度,必要时手术或血滤治疗。结果入院时全组血清甘油三酯>5.65mmol/L,平均为17.5mmol/L,血清肉眼呈乳状;血糖15.33mmol/L;血淀粉酶在123iu～280iu之间。均行CT平扫和/或增强检查,BalthazarCT分级:Ⅰ级11例,Ⅱ级1例。中-重度脂肪肝。全组11例非手术治疗,1例行胰周清创引流术。血脂水平多在4～7天降至正常。均顺利恢复,无死亡。出院后定期监测血脂,口服降脂药物。随访至今,有4例半年内复发再次入院,对症处理后缓解。结论高脂血症性胰腺炎以水肿型多见,非手术治疗为主。降脂治疗能迅速缓解症状。

Objective To investigate the clinical character of hyperlipidemic pancreatitis.Methods The clinical data of 12 patients with hyperqlipidemic pancreatitis between July 1994 andDecember 2005 were analyzed retrospectively. Besides the general treating measures of the acutepancreatitis, it was important to reduce the blood triglyceride, to use intralipid carefully and cut downthe viscosity of blood .Surgery operation and filter blood treatment was taken when it was necessarily.Results All cases＇ blood triglyceride were over 5.65mmol/L level and 17.5mmol/L average.Itseemed milk like by naked eyes.Average of blood sugar was 15.33 mmol/L;Serum amylase wasbetween 123u to 280u. All cases were accepted plain scanning or/and contrast enhancement CTexamination.Under the Balthazar CT granulation：eleven cases of degre I,one case of Degre lI .andfatty liver was found. Eleven cases with non- operative treatment , one case with incision anddrainageof the pancreas. The blood triglyceride level below normal in 4-7 days. All patients were recoveredsmoothly, no dealth. It was regularly to monitor blood [riglyceride and take oral medicine of reducingthe blood triglyceride after them discharged from hospital. It was continuously follow-up visit. Fourcases relapsed in half a year. and went into remission after treat. Conclusion The chief classificationof hyperlipidemic pancreatitis was oedematous acute pancreatitis, the primarily measure was nonoperative treatment. Reducing the blood triglyceride could quicklly alleviate the symptom.