高脂血症性胰腺炎的诊治体会（附33例报告）

Diagnosis and treatment experience of hyperlipidemic pancreatitis （33 cases report）

目的探讨高脂血症性胰腺炎的临床特点和治疗方法。方法回顾性分析33例高脂血症性胰腺炎临床资料，33例患者甘油三酯均≥5．65mmol／L，在5．65～11．3mmol／L之间伴有血清乳糜样者12例，≥11．3mmol／L者21例，最高者达34．47mmol／L；24例为轻型胰腺炎，9例为重型胰腺炎；29例行应用胰岛素和低分子肝素降血脂、血浆置换、液体疗法、促进胃肠道恢复等非手术治疗，4例行手术治疗。结果32例治愈，治愈率为97．0％；1例死亡为重型胰腺炎术后患者。随访2～59个月，6例复发。结论高脂血症可诱发急性胰腺炎，且病情较重。治疗以非手术治疗为主，早期降低血清甘油三酯水平、促进胃肠道功能恢复有助于病情的缓解。

Objective To investigate the clinical features and the treatment of hyperfipidemic panereatitis. Methods A total of 33 patients with hyperlipidemic panereatitis who were admitted to our hospital from January 2005 to October 2009 were retrospectively analyzed. The patients,including 28 males and 5 females, were aged from 19 -61 years old with the mean age of 35.6 years. In all the patients, TG was greater than 5.65 mmoL/L,which ranged from 5.65 to 11.3 mmol/L in accompany with chylous serum in 12 patients, and was higher than ≥ 11.3 mmol/L in 21 patients. The maximum value of TG was up to 34.47 mmoL/L. Twenty - four cases were classified into mild acute pancreatitis （72.7%） and 9 into severe acute panereatitis （27.3%）. Twenty- nine patients were given different non-surgical treatments including administration of heparin and insulin to reduce plasma triglyceride, plasma exchange, fluid therapy, promotion of the recovery of gastrointestinal function and so on. Four patients were treated operatively. Results Thirty - two patients were cured,accounting for 97.0% of all patients,and 1 patient died. The patients were followed for 2 to 59 months. Six patients developed recurrence. Conclusion Hyperlipidemia can trigger acute pancreatitis attacks, and even leads to severe pancreatitis which possesses peculiar clinical features. The treatment for hyperlipidemie pancreatitis is dominated by non - operative management. In early periods, reducing serum trlgiyceride and promoting the recovery of gastrointestinal function can help alleviate the condition.