急性胰腺炎410例住院患者临床分析

目的　探讨急性胰腺炎的临床特点、诊断和治疗的若干问题。方法　对 1993年 1月至 2 0 0 3年 1月期间住院的急性胰腺炎患者 4 10例作回顾性分析 ,总结其临床特点 ;并对不同的诊断方法进行评价。对急性胰腺炎的诊断标准提出意见。结果　腹痛为急性胰腺炎的必有症状 ,呕吐后腹痛不缓解可与急性胃炎相区别。症状、血清酶学及影像检查三者结合可对急性胰腺炎作出正确诊断。腹部 CT对诊断有重要价值。每个急性胰腺炎患者均须给予严密监测 ,以防止其病情发展为急性重症胰腺炎。凡腹痛严重伴有 1个以上的脏器功能障碍表现者 ,即应考虑为急性重症胰腺炎并及时治疗。结论　急性胰腺炎为常见病 ,近年来有增多趋势。重症胰腺炎预后凶险 ,须提高警惕早期诊断 ,并予以有效治疗。

Clinical review on 410 cases of acute pancreatitis in recent ten years

Objective To investigate the clinical features,diagnosis and treatment on acute pancreatitis (AP).Methods The data of 410 cases with AP admitted to Shanxi Provincial Hospital from Jan 1993 to Jan 2003 were analyzed and evaluated as to the clinical manifestations and the value of different diagnostic techniques.The diagnosis of severe acute pancreatits (SAP) was also discussed.Results This study showed that abdominal pain was the chief syndrome of AP,and no relief of pain after vomiting was its character.The diagnosis of AP was dependent on the abdominal syndrome,laboratory test (serum amylase and lipase activity) and imaging examination (ultrasonography and CT).The CT scan was able to visualize the pancreas and peripancreatic space with greater accuracy.The positive rates of the abdominal ultrasonographic and CT data were 84.4% and 90%.So the CT scaning was more useful for the diagnosis of AP.Severe abdominalgic cases complicated with dysfunction of one or more organs were regarded as acute grave pancreatitis and treated promptly.Conclusion The morbidity of AP is tending to increase recently.The prognosis of SAP is unfavourable,so we should make early diagnosis,treating promptly.