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目的:探究左旋门冬酰胺酶在诱发儿童急性胰腺炎方面的重要影响,研究此病发病的临床特征,以减少左旋门冬酰胺酸使用后对急性胰腺炎的诱发,促进患者疾病的康复。方法:以2013年12月-2015年12月,来我院使用左旋门冬酰胺酶进行治疗的300例小儿患者,其中使用后发现出现进行胰腺炎的患者有10例,对这些患者的引发原因、临床症状、实验室检查、治疗方法及效果,进行总结应对左旋门冬酰胺酶引发急性胰腺炎的方法。结果:300例使用左旋门冬酰胺酶进行治疗的儿童患者中,出现急性胰腺炎为10例,发生率为3.33%,大部分的临床症状为急性腹痛4例、腹胀3例、发烧5例、急性休克3例,所有出现急性胰腺炎的患者都出现了血液淀粉酶和血糖的上升,部分患者出现了低血钠和低血钙的情况,胰腺彩超都显示异常。突发的10例急性胰腺炎的患者没有死于急性的休克。应对急性胰腺炎采取的最为常规的急救措施是抢救休克病人并且减少胰腺酶类的分泌。结论:左旋门冬酰胺酶造成儿童出现急性胰腺炎的病例在临床上不多见,但是由于病情凶险所以病患的死忙率较高,特别是出血坏死类的急性胰腺炎发病较快,抢救效果不佳。.综合考虑患者的左旋门冬酰胺酶的用药史和患者的既往史,,密切关注病人出现的腹痛以及是否出现休克的临床表现,定期检测血液淀粉酶的含量,使用腹部B超可以使提前诊断出急性胰腺炎的可能,目前临床上使用较为普遍的应对方法为抢救休克、降低胰酶含量及手术。
Objective: To investigate the important effect of L-asparaginase in inducing acute pancreatitis in children and to study the clinical features of the disease in order to reduce the induction of acute pancreatitis after the use of L-asparagine and to promote the recovery of the disease. METHODS: From December 2013 to December 2015, 300 pediatric patients treated with L-asparaginase in our hospital were enrolled. Among them, 10 patients were found to have pancreatitis, and the cause of these patients , Clinical symptoms, laboratory tests, treatment methods and effects, to summarize the way to deal with L-asparaginase-induced acute pancreatitis. Results: In 300 children with L-asparaginase, 10 cases of acute pancreatitis occurred, the incidence was 3.33%. Most of the clinical symptoms were acute abdominal pain in 4 cases, bloating in 3 cases, fever in 5 cases, Acute shock in 3 cases, all patients with acute pancreatitis appeared in the blood amylase and blood sugar increased, some patients had hyponatremia and hypocalcemia, pancreatic ultrasound showed abnormalities. Sudden cases of acute pancreatitis in 10 patients did not die of acute shock. The most common first-aid response to acute pancreatitis should be to rescue shock patients and reduce pancreatic enzyme secretion. Conclusions: The cases of acute pancreatitis caused by L-asparaginase are rare in clinic, but the incidence rate of death is high due to dangerous condition, especially acute hemorrhagic necrosis of acute pancreatitis. not effectively. .Considering the patient’s history of L-asparaginase medication and the patient’s past history, pay close attention to patients with abdominal pain and whether the clinical manifestations of shock, regular detection of blood amylase content, the use of abdominal B ultrasound can make early diagnosis Out of the possibility of acute pancreatitis, the current clinical use of the more common response to rescue shock, reduce pancreatic enzyme content and surgery.