急诊36例急性胰腺炎诊治体会

Emergency Diagnosis and Treatment of Acute Pancreatitis:Report of 36 cases

目的探讨不同类型急性胰腺炎(AP)的临床特点、诊断和治疗方法 ,以提高临床医生对该病的诊治水平。方法选取我院急诊科AP患者36例为研究对象,回顾性分析其病因、临床表现、实验室检查、治疗及其效果。结果 36例AP患者其中高脂血症性AP17例(47.2%);胆源性AP14例(38.9%);乙型重型肝炎合并AP3例(8.3%);胰头肿块型AP2例(5.6%)。36例患者中20例经内科治愈或好转出院,9例转外科手术治疗,4例死亡,3例自动出院。结论 AP以高脂血症性和胆源性高发,内科综合治疗和严格掌握手术适应证是治疗AP的关键,可以降低该病的病死率。

Objective To investigate the clinical features,diagnosis and treatment of different types of acute pancreatitis （AP） so as to improve the level of diagnosis and treatment of the disease.Methods Totally 36 AP patients in emergency department of our hospital were selected as the subjects,and the data on the etiology,clinical presentation,laboratory findings,treatment and its effects were retrospectively analyzed.Results Among the 36 AP patients 17（47.2%） were hyperlipidemic pancreatitis,14（38.9%） were biliary pancreatitis;3（8.3%） were severe hepatitis B with pancreatitis;and 2（5.6%） were acute pancreatitis with mass in head of pancreas.There were 20 patients who were discharge for cure or improvement by internal medication,9 cases were transferred for surgical treatment,4 cases died,3 cases gave up the treatment.Conclusion Hyperlipidemic and biliary pancreatitis are of high morbidity in acute pancreatitis.The key to treatment of acute pancreatitis are comprehensive medical treatment and strictly grasping the indication of operation so as to reduce the mortality of the disease