急性胰腺炎病因与其严重度的临床分析

Clinical analysis of the etiology and severity of acute pancreatitis

目的探讨急性胰腺炎(AP)的病因及其与疾病严重程度的关系。方法回顾性分析我院2007年1月—2016年12月收治的590例AP患者的临床资料。其中轻度急性胰腺炎(MAP)459例、中度急性胰腺炎(MSAP)68例、重度急性胰腺炎(SAP)63例,分析疾病严重程度与性别、年龄、病因及并发症的关系。结果 3组间年龄、性别、局部并发症发生率比较差异无统计学意义,但SAP组系统并发症发生率高于其他2组(P<0.05)。590例患者中由胆源性疾病导致患病者共352例(59.7%),是最主要的病因;高脂血症性次之(120例,20.3%)。MSAP及SAP组高脂血症性AP患病比例高于MAP组,酒精性AP比例低于MAP组(P<0.05)。SAP患者住院期间死亡7例(1.2%),出院1个月后随访,未发现有因AP而二次住院患者。结论胆源性疾病是导致AP的首要病因,易引发多种并发症,应尽早解除胆系梗阻,阻止病情进展;及早明确病因,对症治疗可改善预后。

Objective To investigate the relationship between the etiology and the severity of acute pancreatitis(AP).Methods The clinical data of590patients with AP who were admitted into our hospital from January2007to December2016were retrospectively analyzed.In these patients there were459patients with mild acute pancreatitis(MAP),68patients with moderate acute pancreatitis(MSAP)and63patients with severe acute pancreatitis(SAP).The relationship between the severity of disease and age,gender,etiologies and complications was analyzed.Results There were no significant differences in age,gender,and incidence rate of partial illness complication between three groups of patients.While the incidence rate of systemic complications was significantly higher in SAP group than that of other two groups(P<0.05).In590patients,352patients(59.7%)were biliary pancreatitis,which was the first leading pathogenesis.There were120patienets(20.3%)were hyperlipidemic pancreatitis,which was the second pathogenesis.The incidence rate of hyperlipidemic AP was significantly higher in MSAP group and SAP group than those of MAP group,while the alcoholic AP was lower(P<0.05).A total of7cases(1.2%)of SAP were dead during hospitalization,and no patients were admitted to hospital for the second time due to AP during the follow ups(1month after discharge).Conclusion Biliary pancreatitis is the primary pathogenesis of clinical acute pancreatitis,and its incidence rate of complication is higher.The obstruction of the biliary obstruction should be relieved as soon as possible to prevent the progression of the disease.Early diagnosis and symptomatic treatment can improve prognosis.