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目的探讨复发性胆源性胰腺炎的临床特点及诱因。方法选取580例胆源性胰腺炎患者作为研究对象,其中200例复发性胆源性胰腺炎患者,380例初发性胆源性胰腺炎患者;回顾性分析200例复发性胆源性胰腺炎患者的临床特点;与380例初发性胆源性胰腺炎患者诱因进行对比分析。结果复发性胆源性胰腺炎临床表现主要为腹痛、恶心、呕吐、腹胀及黄疸;体征主要为腹部压痛、腹肌紧张、休克及出血征象;并发症主要为局部并发症(胆管炎、胰腺脓肿、肠梗阻及腹水)、全身并发症(呼吸、循环及心肾功能衰竭、败血症);治疗方法主要为控制饮食、胃肠减压、支持疗法、抗菌治疗、抗胰酶疗法及手术切除治疗。预后:治愈68例、显效130例、无效2例。诱因主要为胆囊结石、高脂血症、胆道炎症、酒精摄取过量、饮食不当及胆道蛔虫。结论复发性胆源性胰腺炎以中老年男性作为病发高危群体,临床特点具有特异性,及时采取综合性治疗,患者的预后较好。但复发性胆源性胰腺炎的诱因具有多样性,需对因治疗,从而减少复发性胆源性胰腺炎发生的风险。
Objective To investigate the clinical features and causes of recurrent biliary pancreatitis. Methods A total of 580 patients with gallstone pancreatitis were selected as the study subjects, of whom 200 patients with recurrent biliary pancreatitis and 380 patients with primary biliary pancreatitis. Retrospective analysis of 200 cases of recurrent biliary pancreatitis The clinical features of patients with 380 cases of initial biliary pancreatitis incentive comparison. Results The main clinical manifestations of recurrent biliary pancreatitis were abdominal pain, nausea, vomiting, abdominal distension and jaundice. The main symptoms were abdominal tenderness, abdominal muscle tension, shock and bleeding signs. The main complications were local complications (cholangitis, pancreatic abscess , Intestinal obstruction and ascites), systemic complications (respiratory, circulatory and heart failure, sepsis); treatment is mainly diet, gastrointestinal decompression, supportive therapy, antibacterial therapy, anti-pancreatic enzyme therapy and surgical resection. Prognosis: cured 68 cases, 130 cases markedly effective in 2 cases. The main causes of gallbladder stones, hyperlipidemia, biliary inflammation, excessive alcohol intake, improper diet and biliary Ascaris. Conclusion Recurrence of biliary pancreatitis in middle-aged and elderly men as a high risk group, the clinical features of a specific, timely and comprehensive treatment, the prognosis of patients is better. However, the causes of recurrent biliary pancreatitis with diversity, the need for treatment, thereby reducing the risk of recurrent biliary pancreatitis.