33例急性复发性胰腺炎临床分析

Clinical analysis of 33 cases of acute recurrent pancreatitis

目的探讨急性复发性胰腺炎的病因学，以及如何进一步提高其治疗水平。方法对瑞金医院2003—2007年间33例急性胰腺炎复发的病历资料和临床诊治进行整理和分析。结果33例急性复发性胰腺炎中，男性55％，女性45％，平均年龄55岁（22～86岁）。其中复发1次有26例，复发2次4例，复发3次及以上3例。33例病人中，出院后1年内复发29例，1～2年内复发2例，2～3年内复发1例，3年以上复发1例。就病因而言，胆源性有29例，占到绝大部分，高脂血症及胰腺肿瘤因素各1例，另外有2例发病原因不明。经过手术或内镜治疗的有24例。所有病人中死亡2例，病死率9．1％。结论胆道因素是我国急性胰腺炎复发的最常见病因，适时时机的外科介入能有效的降低胆源性胰腺炎的复发几率．

Objective To investigate the etiology of acute recurrent pancreatitis （ACP） and determine how to further enhance its level of treatment. Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed. Results Of the 33 patients with an average age of 55 （22-86）, 18 （55%） were male and 15 （45%） female. ACP occurred once in 26 patients, twice in 4 and 3 times in 3. The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital. For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2. Twenty-four patients were treated with operation or endoscopy. Two patients died and the mortality was 9. 1%. Conclusion ACP is mainly due to biliary origin in China. Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.