小儿急性胰腺炎29例

Acute pancreatitis in 29 children

目的探讨小儿急性胰腺炎(AP)的临床特点及诊治方法,为临床及时诊治AP提供依据。方法对驻马店市中心医院2007年1月至2012年12月收治的29例AP患儿的临床特点、实验室检查、治疗过程及预后进行回顾性分析。结果 29例AP患儿中临床症状以腹痛(24例,82.8%)和呕吐(17例,70.8%)为主;病因以感染因素(14例,48.3%)和胃十二指肠疾病(8例,27.5%)为主;实验室结果血淀粉酶升高20例(79.3%),血脂肪酶升高9例(31.0%),尿淀粉酶升高4例(13.8%);腹部B超14例(48.3%)提示不同程度胰腺组织声像图异常。经内科保守治疗,26例轻型AP患儿均治愈,3例重型AP患儿好转出院。结论小儿AP多以腹痛和呕吐等消化道症状为主,病因与成人不同,早期诊断和病情评估是避免误诊及有效治疗的关键。

Objective To explore the clinical characteristics, diagnosis and treatment of acute pancreatitis（AP） in children in order to provide the basis of early diagnosis and treatment. Methods A total of 29 children with AP were selected in Zhumadian Central Hospital from January 2007 to December 2012. Clinical characteristics, laboratory examination and the process of diagnosis and treatment of them were reviewed and analyzed. Results Abdominal pain （ 82.8% ） and vomiting （70. 8% ） were the major symptoms of AP in the 29 children. Infections （48.3%） and gastroduodenal diseases （27.5 % ） were the main causes of AP in children. The blood amylase,blood lipase and uric amylase increased in 20 cases（79.3% ） ,9 cases （31.0） % and 4 cases（ 13.8% ）respectively. Abdominal ultrasound of 14 cases（48.3% ）prompted different degree abnormal ultrasonogram of pancreatic tissue. After conservative treatment,26 patients with mild AP were cured, and 3 cases of severe AP got better and were discharged. Conclusion Gastrointestinal symptoms such as abdominal pain and vomiting are the main clinical manifestations of AP in children, who have different characteristic in pathogen compared with adults. Early diagnosis and illness state evaluate are the key of avoiding misdiagnosis and effective therapy.