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目的通过对乙型肝炎肝硬化合并急性胰腺炎的病例进行分析,总结其临床特点及预后。方法收集诊断明确的乙型肝炎肝硬化合并急性胰腺炎患者27例,采用回顾统计分析的方法,分别从临床表现、实验室检查、治疗及预后等方面进行总结分析。结果乙型肝炎肝硬化合并急性胰腺炎时均有不同程度的上腹部疼痛,但恶心、呕吐、放射痛、腹肌紧张及发热均不常见,B超检查胰腺显示不清,CT检查显示胰腺周围均有渗出,血清淀粉酶、尿淀粉酶、中性粒细胞比例均不同程度增高,白细胞增高不多见,手术治疗患者均死亡,胰腺炎易反复发作且肝脏损害进一步加重。结论乙型肝炎肝硬化合并急性胰腺炎临床表现不典型,应综合症状、体征及实验室检查及时做出诊断,应以内科综合治疗为主,且患者病情重,预后差。
Objective To analyze the clinical characteristics and prognosis of patients with hepatitis B cirrhosis complicated with acute pancreatitis. Methods Twenty-seven patients with diagnosed hepatitis B cirrhosis complicated with acute pancreatitis were collected and analyzed retrospectively. The clinical manifestations, laboratory tests, treatment and prognosis were analyzed respectively. Results Hepatitis B cirrhosis complicated with acute pancreatitis had varying degrees of upper abdominal pain, but nausea, vomiting, radiating pain, abdominal muscle tension and fever were uncommon. The pancreas showed by the B-mode ultrasonography was unclear. CT examination showed that the pancreas around All exudation, serum amylase, urinary amylase, neutrophil ratio were increased to varying degrees, rare white blood cells, surgical treatment of patients were killed, pancreatitis is easy to recurrent and further aggravate liver damage. Conclusions The clinical manifestations of hepatitis B cirrhosis complicated with acute pancreatitis are not typical. Syndromes, physical signs and laboratory tests should be used to make timely diagnosis. Comprehensive medical treatment should be taken as the main cause. Patients are seriously ill and have poor prognosis.