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目的:研究胆囊切除术后患者发生急性胰腺炎的发病特点。方法:回顾性分析2009年10月至2013年10月四川大学华西医院诊断为急性胰腺炎且既往行胆囊切除术患者的病因、病情严重程度、临床特征与转归。结果:研究共纳入314例患者,以高脂血症性胰腺炎占比最高,共110例(35%),胆源性胰腺炎和混合性胰腺炎分别为107例(32%)、96例(31%),酒精性仅7例(2%)。轻症215例,中度31例,重度68例。高脂血症性胰腺炎患者重症率(36%)、胰腺及胰周坏死率(28%)、持续性器官功能衰竭率(36%)、呼吸衰竭率(41%)、ICU转入率(26%)均显著高于胆源性组和混合组,差异具有统计学意义(P<0.05)。结论:胆囊切除后的急性胰腺炎以胆源性胰腺炎和高脂血症性胰腺炎居多,其中高脂血症性胰腺炎的病情更严重。
Objective: To study the incidence of acute pancreatitis in patients after cholecystectomy. Methods: The etiology, severity, clinical features and prognosis of patients with acute pancreatitis who underwent cholecystectomy at West China Hospital of Sichuan University from October 2009 to October 2013 were retrospectively analyzed. Results: A total of 314 patients were enrolled in this study, with the highest proportion of hyperlipidemic pancreatitis (110 cases, 35%), biliary pancreatitis and mixed pancreatitis (107 cases, 32%) and 96 cases (31%), alcohol only 7 cases (2%). 215 cases of mild, moderate in 31 cases, severe in 68 cases. (36%), pancreatic and peritoneal necrosis (28%), persistent organ failure (36%), respiratory failure (41%) and ICU transfusion rate (26% %) Were significantly higher than the biliary group and mixed group, the difference was statistically significant (P <0.05). Conclusions: Acute pancreatitis after cholecystectomy is mainly gallstone pancreatitis and hyperlipidemic pancreatitis, of which hyperlipidemic pancreatitis is more serious.