急性胰腺炎诊治分析300例

《急性胰腺炎诊治分析300例》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、急性胰腺炎诊治分析300例王隽郭新文(新疆阿克苏地区第一人民医院消化内科新疆阿克苏843000)【摘要】目的:探讨急性胰腺炎的临床特征，总结急性胰腺炎的治疗经验，提高诊治水平。方法:回顾性分析300例急性胰腺炎患者的临床资料。结果:300例急性胰腺炎中，轻症238例(79.3%),重症62例(20.7%)。患胆道疾病者183例(61%),酗酒者41例(13.6%),高脂血症者36例(12%)。腹痛为最常见症状占97.3%。血清淀粉酶水平高于正常上限的总检出率为81.7%,CT诊断总阳性率为93.3%。12例具有胆道梗阻表现的早期进行了内镜下乳头括约肌切开取石和(或)鼻胆管引流。重症胰腺炎行外

2、科手术治疗7例，占其2.3%。结论:胆道疾病、酗酒、高脂血症是急性胰腺炎最常见三大病因;血清淀粉酶和CT是急性胰腺炎较常用和可靠的检查手段；腹痛是急性胰腺炎最主要的临床表现;内镜下乳头括约肌切开取石和(或)鼻胆管引流是解除急性胰腺炎胆道梗阻的安全有效方法;强调以非手术为主的综合治疗,对有早期手术指征和中转手术指征患者应当及时手术治疗。【关键词】胰腺炎临床特征诊断治疗【中图分类号】R657.5+l［文献标识码】A【文章编号】2095-1752(2013)03-0128-02Diagnosisandtreatmentofacutepancreatitis:ananalysisof303cases

3、WANGJuan,GUOXinwen(DepartmentofGastroenterology,TheFirstPeople’sHospitalofAkesucity,AKesu843000China)【Abstract】ObjectivesToinvestigatetheclinicalcharactisticsofacutepancreatitis(AP),andtosummarizetheexperiencesoftreatment,improvethediagnosticlevelandtherapeuticeffect.MethodTheclinicaldataof30

4、0APpatientswereretrospectivelyanalyzed.ResultsInthe300patients,238hadmildacutepancreatitis(MAP)(79.3%),62hadsevereacutepancreatitis(SAP)(20.7%).Asfortheetiology,biliarytractdiseasesaccountedfor61%,alcoholic-induced13.6%,hyperlipidemia12%.Theabdominalpainplayedamajorroleintheclinicalsymptoms(97.3%).

5、81.7%ofthepatientshadserumamylase3timeshigherthantheuppernormallimit.Around93.3%hadcutepancreatitisconfirmedbyCTscan.Inordertorelievebileductobstruction,12casesunderwentendoscopicsphinctero-tomy(EST)and(or)endoscopicnosalbiliarydrainage(ENBD).3severecases(2.3%)receivedsurgicalintervene-tion.Conclus

6、ionsBiliarytractdiseases,alcoholandhyp-erlipidemiaaremainetiologicfactorsofacutepancreatitis.ThemaincausesofAPrelapsingmaybebiliarytractdiseases.SerumamylaseandCTscanarereliablediagnosticmethodsforacutepancreatitis.AbdominalpainisthechiefsyndromeofAP.ThecomplicationsofSAPareexcessiveandcompli-cated

7、,whichshouldbeattractedconsiderableattentionandtreatedpromptly.ThetreatmentofEST/ENBDforAPpat-ientssufferingfrombileductobstructionissafeandeffect-ive.ConservativetreatmentshouldbeaninitialchoiseforSAP.Oper