复发性急性胰腺炎的临床特征及内镜诊治分析

发布时间：2018-03-21 19:01

本文选题：急性胰腺炎　切入点：复发　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:分析复发性急性胰腺炎(RAP)的临床特点、病因及其内镜诊治情况,评估内镜诊治在该病中的诊疗价值。方法:选择我院开展ERCP诊治后自2013年1月至2015年10月期间住院治疗的急性胰腺炎患者,根据随访后的结果按照是否复发分为单发组和复发组两组。分析两组的临床特征及内镜诊治情况。结果:入组1042例AP患者,单发组781例,占总的急性胰腺炎的比率为74.95%;复发组261例,占25.05%。两组年龄、SAP比例无显著差异(P0.05),而性别(P=0.003)、胰腺假性囊肿所占比例(P=0.039)比较有显著差异;复发性急性胰腺炎距初次发病半年内复发率最高(127例,占48.66%)。Logistic回归分析:胆源性(OR1.812;95%CI 1.311~2.506)、高脂血症(OR 2.162;95%CI 1.446~3.233)、胰胆管解剖异常因素(OR 2.712;95%CI 1.397~5.263)是急性胰腺炎反复发作的危险因素。在不明病因的RAP患者中,有14例患者行超声内镜检查,病因诊断阳性率71.43%(10/14);35例行ERCP检查,病因诊断阳性率82.85%(29/35)。共58例RAP患者行ERCP治疗,治疗后总缓解率达87.5%。结论:胆源性、高脂血症及胰胆管畸形因素是AP复发的危险因素;内镜治疗能显著降低RAP的复发率,是对RAP有重要价值的诊断和治疗手段。
[Abstract]:Objective: to analyze the clinical features, etiology and endoscopic diagnosis and treatment of recurrent acute pancreatitis (rapp). Methods: to evaluate the value of endoscopic diagnosis and treatment in the diagnosis and treatment of the disease. Methods: select the patients with acute pancreatitis who were hospitalized from January 2013 to October 2015 after ERCP treatment in our hospital. According to the results of follow-up, the patients were divided into two groups: single group and recurrent group. The clinical characteristics, endoscopic diagnosis and treatment of the two groups were analyzed. Results: 1042 cases of AP were included in the study, and 781 cases in the single group. The ratio of acute pancreatitis to total acute pancreatitis was 74.95%, the recurrence group was 261 cases (25.05%). There was no significant difference in the ratio of SAP between the two groups (P 0.05), but there was a significant difference between the two groups in the proportion of P0. 003 and pseudocyst of pancreas (P < 0. 039). The recurrence rate of recurrent acute pancreatitis was the highest in 127 cases within half a year from the first onset. In 48.66%).Logistic regression analysis, OR 1.81295 CI 1.3112.506, OR 2.16295 CI 1.4463.233, OR 2.71295 CI 1.3975.263) were the risk factors of recurrent acute pancreatitis. In 14 RAP patients with unknown etiology, endoscopic ultrasonography was performed. The positive rate of etiological diagnosis was 71.43 / 10 / 14 / 35 ERCP, and the positive rate of etiological diagnosis was 82.85 / 29 / 35. 58 cases of RAP were treated with ERCP, and the total remission rate was 87.5%. Conclusion: the risk factors of AP recurrence are biliary origin, hyperlipidemia and pancreaticobiliary malformation. Endoscopic therapy can significantly reduce the recurrence rate of RAP and is an important diagnostic and therapeutic method for RAP.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R576

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