维持性腹膜透析和血液透析患者的急性胰腺炎(附9例报告)

Acute Pancreatitis in Long Term Peritoneal Dialysis and Hemodialysis Patients (Report of 9 Cases)

目的 探讨维持性腹膜透析 (PD)和血液透析 (HD)患者发生急性胰腺炎 (AP)的可能原因及其诊断与治疗。方法 回顾性分析 1993年 1月至 2 0 0 0年 1月期间我院进行透析治疗的患者中发生 9例AP的临床资料。结果 9例患者血清淀粉酶均达正常上限值的 3.5倍以上 ,B超和CT检查对确诊AP起了一定作用。经保守治疗后 8例患者恢复良好 ,1例重症胰腺炎治疗无效而死亡。结论 维持性腹膜或血液透析患者具有多种潜在发生AP的危险因素。血清淀粉酶的检测是明确诊断的重要依据 。

Objective To assess the possible causes of acute pancreatitis (AP) in long term peritoneal dialysis (PD) and hemodialysis (HD) patients, and to discuss the diagnosis and treatment of AP in this kind of patients. Methods The clinical data of 9 cases of AP in PD and HD patients who were admitted in the hospital during January 1993 and January 2000 were analysed retrospectively. Results The serum levels of amylase of all the 9 cases were over three and a half times of upper limit value of healthy subjects. B mode ultrasound and CT scan examinations were useful for diagnosis of AP. Eight patients recovered very well with conservative treatment, while one patient who was diagnosed as acute severe pancreatitis and complicated with shock died. Conclusion Long term PD and HD patients are predisposing to develop AP. Diagnosis of AP in these patients primarily depends on the detection of serum amylase. Dialysis treatment is indispensable for cure of AP.