论文部分内容阅读
目的 探讨复发性急性胰腺炎(RAP)的病因及治疗方案的选择.方法 回顾性分析内江市第二人民医院2012年1月-2015年12月收治的284例急性胰腺炎(AP)患者,其中初发性急性胰腺炎患者232例(初发组),RAP患者52例(复发组).收集2组患者的一般情况、病因、复发次数、复发间隔时间、治疗方案及转归情况.计量资料组间比较采用t检验,计数资料组间比较采用χ2检验.结果 复发组胆源性因素、高脂血症因素高于初发组(66.8%vs 35.8%,χ2=7.109,P=0.008;17.3%vs 16.0%,χ2=5.818,P=0.007),而饮食因素复发组要低于初发组(7.7%vs 21.1%,χ2=5.046,P=0.025).复发组52例患者中,复发1次33例(63.46%)、复发2次14例(26.92%)、复发3次及以上5例(9.62%);距初次发病间隔6个月内12例(23.08%),间隔6~12个月内23例(44.23%),间隔12个月及以上17例(32.69%).RAP组52例患者中23例行手术治疗、23例行保守治疗、6例行内镜治疗,随访观察6~24个月,无死亡病例,无复发病例.结论 RAP病因复杂,其中胆源性因素及高脂血症与AP复发密切相关,治疗上应明确病因,积极对因治疗,可有效降低AP复发率.“,”Objective To investigate the etiology of recurrent acute pancreatitis (RAP)and selection of treatment regimen. Methods A retrospective analysis was performed for the clinical data of 284 patients with acute pancreatitis (AP)who were admitted to The Second Peo-ple′s Hospital of Neijiang from January 2012 to December 2015,and among these patients,232 had incipient AP (incipient group)and 52 had RAP (recurrent group). The two groups were analyzed in terms of general status,etiology,number of times of recurrence,recurrence interval,treatment regimen,and prognosis. The t - test was used for comparison of continuous data between groups,and the chi - square test was used for comparison of categorical data between groups. Results Compared with the incipient group,the recurrent group had a sig-nificantly higher proportion of patients with biliary factors (66. 8% vs 35. 8%,χ2 = 7. 109,P = 0. 008)or hyperlipidemia (17. 3% vs 16. 0%,χ2 = 5. 818,P = 0. 007),as well as a significantly lower proportion of patients with diet factors (7. 7% vs 21. 1%,χ2 = 5. 046, P = 0. 025). Among the 52 patients in the recurrent group,33 (63. 46%)had one time of recurrence,14 (26. 92%)had two times of re-currence,and 5 (9. 62%)had three or more times of recurrence;as for recurrence interval,12 (23. 08%)had a recurrence interval of less than 6 months,23 (44. 23%)had a recurrence interval of 6 - 12 months,and 17 (32. 69%)had a recurrence interval of more than 12 months;as for the selection of treatment regimen,23 underwent surgical treatment,23 underwent conservative treatment,and 6 underwent endoscopic therapy. These patients were followed up for 6 - 24 months,and no patient died or experienced recurrence. Conclusion RAP has a complex etiology,and biliary factors and hyperlipidemia are closely associated with the recurrence of AP. Identification of etiology and active etiological treatment can effectively reduce the recurrence rate of AP.