复发性急性胰腺炎相关危险因素及治疗分析

Analysis of related risk factors and treatment of recurrent acute pancreatitis

目的探讨复发性急性胰腺炎(recurrent acute pancreatitis,RAP)的相关危险因素及治疗方法,为临床防治提供可借鉴的经验。方法回顾性分析2013年1月至2016年1月重庆医科大学附属第一医院收治的269例RAP住院患者临床资料,分析其反复发作危险因素,并根据治疗方式将其分为三组(药物、手术、内镜组),随访并评估其疗效。结果多因素分析显示,暴饮暴食(OR=2.25,P=0.02)、血清高甘油三酯(OR=3.53,P<0.01)、高血糖(OR=1.23,P=0.04)和CT评分(OR=3.92,P<0.01)为AP复发的独立危险因素。三组在随访期内的复发率分别为53.45%、17.91%、12.79%,差异有显著统计学意义(P<0.01)。结论暴饮暴食、血清高甘油三脂、高血糖、CT评分与RAP发生密切相关。对RAP患者采取针对性治疗,可有效提高治愈率、减少复发。

Objective To analyze the related risk factors and treatment of recurrent acute pancreatitis（ RAP）,and to provide reference for clinical prevention and treatment. Methods Two hundred and sixty-nine cases of RAP hospitalization in the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Jan. 2016 were analyzed retrospectively,the risk factors of recurrent were analyzed. According to the treatment,patients were divided into three groups（ drugs group,surgery group,endoscopic group） were analyzed,then the curative effects were followed up and assessed. Results Multivariate analysis showed that overeating（ OR = 2. 25,P = 0. 02）,high serum triglyceride（ OR= 3. 53,P〈0. 01）,hyperglycemia（ OR = 1. 23,P = 0. 04） and CT score（ OR = 3. 92,P〈0. 01） were independent risk factors of RAP. The recurrence rates of three groups were 53. 45%,17. 91%,and 12. 79% in drugs group,surgery group and endoscopic group,the difference was statistically significant（ P〈0. 01）. Conclusion Overeating,high serum triglyceride,hyperglycemia,CT score are closely related to the occurrence of RAP. Targeted treatment of RAP patients can effectively improve the cure and reduce recurrence.