儿童急性胰腺炎的诊断和治疗

Diagnosis and Treatment of Children with Acute Pancreatitis

目的通过对48例儿童急性胰腺炎的诊治过程的总结,分析儿童急性胰腺炎的临床特点,总结治疗经验。方法回顾2007年至2012年我院收治的48例急性胰腺炎患儿,分析其病因,经临床体征,辅助检查确诊后临床采用禁饮食胃肠减压、抗感染、抑制胰液分泌、抗炎抑酶等治疗。其中1例系腹部复合性外伤导致创伤性胰腺炎合并多器官功能衰竭死亡。其余患儿通过保守治疗均治愈。结果急性胰腺炎在儿童发病率近年有所升高。治疗上使用广谱抗生素,抑制胰腺分泌,抗炎抑酶等措施有效。本组1例外伤所致创伤性胰腺炎伤情过重,虽经积极救治但死于多器官功能衰竭。结论临床医师应提高对儿童胰腺炎的认识,早期明确诊断,采用抗感染,抗炎抑酶等治疗效果较好。对于重症患儿应借鉴成人治疗方案,积极地多学科协同治疗。

Objective To summarize the process of diagnosis and treatment of 48 children with acute pancreatitis, analyze the clinical characteristics of children with acute pancreatitis, and summarize the treatment experience. Methods 48 children with acute pancreatitis treated in our hospital from 2007 to 2012 were analyzed retrospectively. All cases received the treatment of forbidden diet, gastrointestinal decompression, resistance to infection, inhibition of pancreatic secretion, anti-inflammatory and antimicrobial enzyme after diagnosed by the clinical sign and assistant examination. One case died of abdomen compound trauma caused by traumatic pancreatitis with multiple organ failure. The rest children were cured by conservative treatment. Results The incidence of acute pancreatitis in children increased in recent years. The use of broad-spectrum antibiotics treatment, restrain the pancreatic secretion, anti-inflammatory and antimicrobial enzyme treatment were effective. The case of trauma caused by traumatic acute pancreatitis injury was serious, and died of multiple organ failure although taking positive treatment. Conclusions Clinical doctors should improve the understanding of children＇s acute pancreatitis, early diagnosis, anti-infection, anti-inflammatory and antimicrobial enzyme treatment has better effect. For children with severe acute pancreatitis, treatment plans will be learned from adult, in order to take active multidisciplinary collaborative treatment.