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目的分析急性胰腺炎引起的急性胃肠黏膜病变(acute gastrointestinal mucosal lesions,AGML)的临床特征以及对胰腺炎治疗和转归的影响。方法152例急性胰腺炎患者在入院后1~4d内用电子胃镜检查上消化道AGML的发病情况,分析AGML的损伤类型和发病部位。根据有无AGML将患者分成两组,分析AGML和急性胰腺炎多项临床指标的关系。结果152例患者中有87例(57%)发现AGML,男性居多(P<0.01)。年龄、病因、血清淀粉酶以及住院天数和AGML之间无显著关联。重症(坏死型)急性胰腺炎AGML发生率显著高于轻型(水肿型)急性胰腺炎(P<0.05)。急性胰腺炎的不同病因和AGML发生的部位无关。急性胰腺炎导致的AGML以胃部多发的浅表性损伤为主。采用制酸剂治疗后,AGML对患者平均住院天数没有影响。结论AGML是急性胰腺炎临床常见的并发症,在男性患者以及在重型急性胰腺炎中更常见。胃镜检测对早期治疗急性胰腺炎导致的AGML有指导作用。
Objective To analyze the clinical characteristics of acute gastrointestinal mucosal lesions (AGML) caused by acute pancreatitis and the effects on the treatment and prognosis of pancreatitis. Methods A total of 152 patients with acute pancreatitis were examined by electron gastroscope for the incidence of AGML in the upper gastrointestinal tract within 1 ~ 4 days after admission. The types and locations of AGML lesions were analyzed. Patients were divided into two groups according to the presence or absence of AGML, and the relationship between AGML and acute pancreatitis was analyzed. Results Of the 152 patients, 87 (57%) found AGML, mostly male (P <0.01). Age, etiology, serum amylase, and length of hospital stay were not significantly associated with AGML. The incidence of AGML in severe (necrotic) acute pancreatitis was significantly higher than that in mild (edematous) acute pancreatitis (P <0.05). The different causes of acute pancreatitis have nothing to do with the site of AGML. AGML caused by acute pancreatitis mainly in superficial gastric lesions. After treatment with antacids, AGML had no effect on the average length of stay in patients. Conclusion AGML is a common clinical complication of acute pancreatitis and is more common in male patients and in severe acute pancreatitis. Gastroscopy for early treatment of acute pancreatitis caused by AGML guidance.