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目的探讨高脂血症性重症急性胰腺炎的临床特点。方法回顾近8年收治的114例重症急性胰腺炎(SAP)患者的临床资料,比较高脂血症组(HL组21例)和非高脂血症组(NHL组93例)的临床特征、并发症及预后差异。结果高脂血症性重症急性胰腺炎(HL-SAP)在性别组成、年龄、ranson评分方面与非高脂血症组均无统计学差异(P>0.05);但体质量指数[(24.451±3.752)vs.(22.468±2.434),P=0.030],既往胰腺炎发作史(23.8%vs.7.5%,P=0.046)及血性腹水发生率(95.24%vs.46.24%,P<0.001)两组间差异有统计学意义;腹腔脓肿,ARDS,肾衰竭,应激性溃疡,DIC,假性囊肿等并发症发生率两组间差异均无统计学意义(P>0.05);MODS发生率HL组高于NHL组(52.4%vs.29%,P=0.04);手术率(66.7%vs.80.6%,P=0.178),住院天数[(25.476±14.383)vs.(22.796±7.191),P=0.216)]及病死率(28.6%vs.11.8%,P=0.069)两组间差异无统计学意义。结论HL-SAP具有体质量较重、多有既往发作史及血性腹水发生率较高,易发生多器官衰竭等特点。
Objective To investigate the clinical features of hyperlipidemic severe acute pancreatitis. Methods The clinical data of 114 patients with severe acute pancreatitis (SAP) treated in recent 8 years were retrospectively analyzed. The clinical features of hyperlipidemia group (21 cases in HL group) and non-hyperlipidemia group (93 cases in NHL group) were compared. Complications and prognosis. Results There was no significant difference in sex composition, age, ranson score and hyperlipidemia among hyperlipidemic severe acute pancreatitis (HL-SAP) (P> 0.05), but body mass index [(24.451 ± (23.8% vs.7.5%, P = 0.046) and the incidence of bloody ascites (95.24% vs.46.24%, P <0.001) compared with the control group (3.752 vs. vs. 22.468 ± 2.434, P = 0.030) The incidence of complications such as abdominal abscess, ARDS, renal failure, stress ulcer, DIC, pseudocyst had no significant difference between the two groups (P> 0.05). The incidence of MODS (52.4% vs.29%, P = 0.04). The operative rate (66.7% vs.80.6%, P = 0.178), length of stay [(25.476 ± 14.383) vs. (22.796 ± 7.191), P = 0.216)] and mortality (28.6% vs.11.8%, P = 0.069). There was no significant difference between the two groups. Conclusion HL-SAP has the characteristics of heavier body weight, more previous history of seizures and higher incidence of bloody ascites and prone to multiple organ failure.