复发性急性胰腺炎的临床特点及其常见病因分析

Clinical Features and Common Etiologies of Recurrent Acute Pancreatitis

目的分析复发性急性胰腺炎(AP)的临床特点、常见病因及预防措施。方法回顾性分析2008年10月至2011年11月期间笔者所在医院收治的43例复发性AP患者的临床特点及影像学检查数据,并与同期收治的258例初发性AP患者进行比较,分析复发性AP患者的复发原因。结果复发性AP与初发性AP患者在发热、黄疸、腹痛缓解时间、胰腺局部并发症以及重症AP患者比例方面差异均无统计学意义(P>0.05)。复发性AP与初发性AP患者的发病原因比较,初发性AP患者发病原因以饮食因素(大量饮酒或暴饮暴食)及结石性胆囊炎为主(P值分别为0.038和0.006),但复发性AP患者以高脂血症及胆总管微小结石和十二指肠乳头疾病(狭窄或憩室)居多(P值分别为0.007和0.008)。针对复发性AP患者的发病原因进行治疗后随访观察3个月～2年(平均14.2个月),无一例复发。结论寻找复发性AP准确的病因并针对病因进行早期治疗是治疗及预防胰腺炎复发的关键所在。

Objective To analyze the clinical features,common etiologies,prevention measurements of recurrent acute pancreatitis（AP）.Methods The clinical characteristics and imaging examination data of 43 patients with recurrent AP were analyzed retrospectively,which was compared with the results of 258 patients with primary AP.The recurrence etiologies were analyzed.Results There were no significant differences on the fever,jaundice,abdominal pain relief time,pancreatic local complications,and ratio of severe AP between two groups（P0.05）.Comparion of etiologies between recurrent AP and primary AP,cholecystitis and diet factor（alcoholic） had priority in patients with primary AP（P=0.038,P=0.006,respectively）,but the hyperlipidemic,duodenal nipple disease,and small stone in the common bile duct were the major etiologies in patients with recurrent AP（P=0.007,P=0.008,respectively）.No relapse was found within the follow up for 3 months to 2 years（the average time was 14.2 months）.Conclusion Find out the exact etiology and performe correct therapy are the key to the treatment and prevention of recurrent AP.