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目的:探讨儿童急性胰腺炎的病因、临床特征及诊治的临床特点,为其临床诊断和治疗提供参考依据。方法:回顾性分析2009年1月～2012年6月我院诊治的107例儿童急性胰腺炎患者的临床资料(病因、临床特点、症状体征、实验室检查、影像学特征、诊断证据、治疗及预后等),综合比较儿童急性胰腺炎与成人急性胰腺炎的不同。结果:107例儿童急性胰腺炎,主要以腹痛为首发症状(81.3%),10例出现腹胀(9.3%),7例出现恶心或呕吐(6.5%),其他或主诉不明确者3例(2.8%)。季节性不明显,四季可发病。PAP的原因中特发性占近40%,其次是外伤和先天性畸形,胆道结石致使的胰腺炎多发于年龄偏大儿童,药物、系统性疾病也均可导致PAP。单纯靠症状诊断PAP有困难,需结合血尿淀粉酶的变化及胰腺影像学检查的结果共同诊断。PAP的治疗强调个体化,科学,合理,及时的补液,及时的生长抑素、抗生素的使用至关重要(不同于成人急性胰腺炎),手术也是必需的备选手段,但需注意手术适应症和时机的选择。结论:儿童急性胰腺炎的发病率呈上升趋势,其诊断和治疗均有其自身的特点,与成人急性胰腺炎并不完全相同,在临床诊断和治疗中应引起足够的重视。
Objective: To investigate the etiology, clinical features and diagnosis and treatment of acute pancreatitis in children and provide reference for its clinical diagnosis and treatment. Methods: The clinical data of 107 children with acute pancreatitis treated in our hospital from January 2009 to June 2012 were retrospectively analyzed (etiology, clinical features, symptoms and signs, laboratory tests, imaging features, diagnostic evidence, treatment and Prognosis, etc.), a comprehensive comparison of children with acute pancreatitis and acute pancreatitis different. Results: Acute pancreatitis was found in 107 children with abdominal pain as the first symptom (81.3%), abdominal distension (9.3%) in 10, nausea or vomiting in 7 (6.5%), and other %). Seasonal is not obvious, the four seasons can be disease. Causes of PAP accounted for nearly 40% of idiopathic, followed by trauma and congenital malformations, biliary stones-induced pancreatitis in older children, drugs, systemic diseases can also cause PAP. Diagnosis of PAP alone is difficult due to symptoms, combined with changes in serum amylase and pancreatic imaging findings of the common diagnosis. PAP treatment emphasizes individualized, scientific, reasonable and timely rehydration, timely somatostatin, the use of antibiotics is very important (different from adult acute pancreatitis), surgery is also an option, but need to pay attention to surgical indications And the timing of the choice. Conclusion: The incidence of acute pancreatitis in children is on the rise. Its diagnosis and treatment have their own characteristics. They are not exactly the same as acute pancreatitis in adults, and should be given enough attention in clinical diagnosis and treatment.