急性胰腺炎患者胃流出道梗阻80例临床特征分析

Clinical characteristics of 80 cases of gastric outflow tract obstruction in patients with acute pancreatitis

回顾性分析2016年1月—2020年12月在天津市中医药研究院附属医院和天津武警特色医学中心收治的确诊为胃流出道梗阻的急性胰腺炎患者80例临床资料,其中男59例,女21例,年龄32~69(47.38±14.62)岁。早期(≤4周)胃流出道梗阻45例(56.25%),晚期(>4周)胃流出道梗阻35例(43.75%)。胃流出道梗阻发病有2个高峰时间,第一个峰值出现在急性胰腺炎发病第13天,第二个峰值出现在急性胰腺炎发病第65天。胰腺坏死压迫(27/45,60.00%)是早期胃流出道梗阻的主要原因,而包裹性坏死(30/35,85.71%)是晚期胃流出道梗阻的主要原因。早期胃流出道梗阻患者病死率为20.00%(9/45),晚期胃流出道梗阻患者均未死亡。胃流出道梗阻是急性胰腺炎患者少见并发症,在急性胰腺炎病程中有2个高峰,需要引起重视。

The clinical data of 80 patients with acute pancreatitis diagnosed as gastric outflow tract obstruction treated in the Affiliated Hospital of Tianjin Institute of Traditional Chinese Medicine and Tianjin Armed Police characteristic medical center from January 2016 to December 2020 were analyzed retrospectively.There were 59 males and 21 females,aged from 32 to 69(47.38±14.62)years.Early(≤4 weeks)gastric outflow tract obstruction in 45 cases(56.25%),late(>4 weeks)gastric outflow tract obstruction in 35 cases(43.75%).There are two peaks in the onset of gastric outflow tract obstruction.The first peak appears on the 13th day of acute pancreatitis and the second peak appears on the 65th day of acute pancreatitis.Pancreatic Necrotic compression(27/45,60.00%)was the main cause of early gastric outflow tract obstruction,while wrapping necrosis(30/35,85.71%)was the main cause of late gastric outflow tract obstruction.The mortality of patients with early gastric outflow tract obstruction was 20.00%(9/45),and none of the patients with late gastric outflow tract obstruction died.Gastric outflow tract obstruction is a rare complication in patients with acute pancreatitis.There are two peaks in the course of acute pancreatitis,which need to be paid attention.