32例儿童急性胰腺炎诊治分析

The diagnosis and treatment of 32 acute pancreatitis in children

目的：探讨儿童急性胰腺炎的发病因素和诊治方法。方法回顾性分析2010年1月至2014年3月我们治疗的32例急性胰腺炎患儿临床资料。结果32例患儿中，胆源性胰腺炎12例（37．5％），外伤性胰腺炎8例（25％），特发性胰腺炎12例（37．5％）。急性轻型胰腺炎24例（75％），急性重症胰腺炎8例（25％）。26例通过非手术治疗治愈。4例合并胆总管囊肿患儿行胆道外引流术后治愈。1例胆总管囊肿合并胰腺炎患儿行胆道外引流术后，胰腺炎仍反复发作，行内镜下乳头括约肌切开（Endoscopic sphincteropapillotomy，EST）和鼻胆管引流（Endoscopic nosal biliary drainage，ENBD）后治愈。1例合并胰腺脓肿患儿行 B 超引导下行经皮穿刺置管引流后治愈。结论儿童急性胰腺炎以胆源性胰腺炎、外伤性胰腺炎为主，大部分患儿可通过非手术治疗治愈，复发性胰腺炎和合并局部并发症的胰腺炎可考虑内镜治疗和外科手术干预。

Objetive To explore the morbidity factors and the way of diagnosis and treatment acute pan-creatitis in children.Methods The clinical date of 32 children with acute pancreatitis was collected and ana-lyzed retrospectively.Results 12 cases were biliary pancreatitis（37.5%）,8 cases were injured pancreatitis （25%）,12 cases were Idiopathic pancreatitis（37.5%）.24 cases were mild acute pancreatitis（75%）,8 ca-ses were sever acute pancreatitis（25%）.26 case were cured by non-surgical treatmen.4 cases with congenital choledochocyst were cured by external drainage of biliary tract.The pancreatitis recured repeatedly in 1 case with congenital choledochocyst who was cured by external drainage of biliary tract.The patient was cured by （EST Endoscopic sphincteropapillotomy）and （ENBD Endoscopic nosal biliary drainage）.1 case with pancre-atic abscess was cured by percutaneous puncture drainage. Conclusions The etiology is mainly the disease of biliary tract and injury in surgery.Most patients are cured by non-surgical treatment.The therapeutic endosco-py and surgery should be considered for patients with recurrent pancreatitis and local complication.