急性胰腺炎患者病因及胰腺外损害的临床分析

Etiology and clinical features of extra-pancreatic impairment in patients with acute pancreatitis

目的探讨急性胰腺炎(Acute pancreatitis,AP)患者病因及胰腺外损害的临床特征。方法分析59例AP患者的病历资料,观察其病因、胰腺外损害的临床特征以及预后的关系。结果59例AP患者以胆源性病因为主,占66.1%。其次是饮酒及饮食因素。78.6%的AP患者合并胰腺外损害,且胰腺外损害部位依次为肝脏74.6%、呼吸道18.6%、胃肠道11.8%。肾功能不全、心功能不全、胰性脑病等较少见。其中28.1%的AP患者合并2种或2种以上器官受损,与无胰腺外损害的AP患者相比,病死率升高、住院天数明显延长。结论AP是一种可累及多系统的疾病,合并胰腺外损害者病死率升高,恢复较慢。

Objective To study the etiology and clinical features of extra-pancreatic impairment in patients with acute pancreatitis （AP）. Methods Medical history materials of 59 patients with AP were studied retrospectively. The etiology, clinical features of extra-pancreatic impairment and prognosis of these patients were observed. Results Of the 59 patients, biliary disease was the most common cause of AP （66.1%）. The other factors were inappropriate diet and alcoholic. Patients with extra-pancreatic impairment accounted for 78. 6% of all the patients. And liver malfunction was the most frequent extra-pancreatic impairment （74.6% ）, followed by respiratory （18.6 %）, gastroenteric impairment （11.8 %）. Renal malfunction, heart malfunction and pancreatic encephalopathy occurred rarely. 28.1% patients with AP had two or more extra-pancreatic impairment. Compared with patients without extra-pancreatic impairment, the death rate of patients with extra-pancreatic impairment was higher, and the hospitalization duration was longer （P〈0. 05）. Conclusion AP is a disease affecting multiple system and organs. AP patients with extra-pancreatic impairment often have a high mortality and slow recovery.