胆源性和高脂血症性胰腺炎临床分析

目的 分析胆源性和高脂血症性胰腺炎临床不同特点.方法 比较2009年2月-2012年8月西安市中心医院收治的48例胆源性胰腺炎患者（A组）和同期16例高脂血症性胰腺炎患者（B组）的临床资料.结果 与A组相比,B组患者发病年龄轻,以男性居多,白细胞增高比率较高,严重肝损害及血尿淀粉酶增高比率较低,CT检查有胰腺形态改变者比率较高,合并脂肪肝及糖尿病患者较多,两组比较差异均有统计学意义（P＜0.05）.结论 胆源性和高脂血症性胰腺炎临床特点不同,高脂血症性胰腺炎血尿淀粉酶增高不明显,CT检查阳性率较高,可在诊断时多加应用;高脂血症性胰腺炎患者治疗中更应注意控制血脂和改善微循环.     

中西医结合治疗高脂血症性急性胰腺炎62例临床研究

目的探讨高脂血症性急性胰腺炎的中西医结合治疗及疗效。方法回顾分析我院经中西医结合治疗的62例高脂血症性急性胰腺炎患者的临床资料。结果全组病例均行血液滤过，3例行腹腔镜胰周清创引流术，59例非手术治疗，62例均痊愈出院。结论本病一经诊断，应通过血滤，在短期内将甘油三酯水平降到5．65mmol／L以下，同时配以中西医结合治疗，防止急性胰腺炎重型化，提高治愈率。     

高脂血症性急性胰腺炎临床分析

目的 探讨高脂血症性急性胰腺炎的临床特点和治疗要点.方法 回顾214例急性胰腺炎患者,其中18例高脂血症性急性胰腺炎、196例其他病因急性胰腺炎的临床特点和治疗进行比较分析.结果 高脂血症胰腺炎的 TG 水平、脂肪肝发生率、SAP 患病率均明显高于其他病因胰腺炎.结论 高脂血症所致急性胰腺炎的发病率呈上升趋势.其临床表现和治疗方法均有其不同的特点.     

糖尿病并高脂血症性胰腺炎18例临床分析

回顾性分析我院2002年9月～2008年6月间18例糖尿病并高脂血症性胰腺炎的资料,探讨糖尿病并高脂血症性胰腺炎的临床特点。结果在18例病例中,经过积极治疗,全部治愈。结论重视糖尿病患者的综合治疗,预防高脂血症性胰腺炎的发生。     

糖尿病并高脂血症性胰腺炎22例临床分析

目的探讨对糖尿病合并高脂血症性胰腺炎患者进行临床分析。方法此次临床研究主要以该院在2013年1月—2014年2月收治的22例糖尿病合并高脂血症性胰腺炎患者为对象,对所有研究对象进行回顾性分析,总结糖尿病合并高脂血症性胰腺炎临床发病的特点以及预防和治疗经验。结果该研究的22例患者经过科学的治疗,最终无一例死亡,全部痊愈出院。结论控制糖尿病患者血糖并采取多种手段的综合治疗,改善预后,减少高脂血症性胰腺炎的发生率。     

高脂血症与急性胰腺炎临床相关性分析

目的探讨高脂血症与急性胰腺炎（AP）的临床相关性及高脂血症性急性胰腺炎（AHLP）的临床特点和治疗要点。方法对237例急性胰腺炎患者进行回顾性分析,根据病因将其分为胆源性急性胰腺炎（151例）、高脂血症性急性胰腺炎（52例）、酒精性急性胰腺炎（16例）和其他（18例）。着重对胆源性急性胰腺炎与高脂血症性急性胰腺炎的临床特点和治疗进行比较分析。结果胆源性急性胰腺炎与高脂血症性急性胰腺炎患者的甘油三酯水平、脂肪肝发生率、重症胰腺炎（SAP）发生率、复发率、手术率、糖尿病发生率、性别、年龄等比较均有显著性差异。CT严重指数、APACHEⅡ评分和Ranson评分比较差异均无显著性。结论高j舌血症性急性胰腺炎在临床特点和治疗方法上都与其它类型急性胰腺炎不同,应作为一种独特的亚型予以重视并区别对待。     

糖尿病并发急性胰腺炎40例临床分析

目的了解糖尿病（DM）合并急性胰腺炎（AP）的临床特点,提高对糖尿病并发急性胰腺炎的诊断及治疗的认识。方法回顾性分析苏州大学附属第一医院2007年1月-2011年1月糖尿病并发急性胰腺炎40例的临床资料,总结糖尿病并发急性胰腺炎的临床特点。结果40例中12例（30．0％）临床诊断为急性重症胰腺炎,8例（20．0％）合并糖尿病酮症酸中毒（DKA）,22例（55．0％）有胆源性疾病,22例（55．0％）有高脂血症。36例（90．0％）经过内科保守治疗治愈,3例（7．5％）死亡,1例（2．5％）转上海医院继续治疗。结论糖尿病病人常并发代谢紊乱,导致高脂血症、胆石症,易诱发胰腺炎,并发DKA,AP患者急性炎症反应又加重各器官的损害,如此反复形成恶性循环,病情较重,应及早诊治,综合治疗,提高治愈率。     

糖尿病并高脂血症性胰腺炎22例临床分析

目的探讨糖尿病并发高脂血症性胰腺炎临床特点及治疗效果。方法研究对象选取该院在2017年10月—2018年10月期间收治的22例糖尿病并高脂血症性胰腺炎,对所有患者临床资料进行回顾性分析,探讨患者临床特点及治疗效果。结果患者经治疗后,APACHE Ⅱ评分、CT严重度指数明显低于治疗前,且空腹血糖、餐后2 h血糖、总胆固醇、糖化血红蛋白及三酰甘油水平明显低于治疗前,差异有统计学意义(P0.05)。结论糖尿病合并高脂血症性胰腺炎患者临床上以低密度脂蛋白水平与甘油三酯的升高为主,需要采取多种手段综合治疗,以减少高脂血症性胰腺炎发生。     

安徽省第二人民医院近4年急性胰腺炎患者的临床特点

目的:探讨安徽省第二人民医院近4年急性胰腺炎患者的临床特点,为其临床研究提供可参考依据.方法:选择2010-01/2014-10 235例急性胰腺炎患者作为研究对象,详细记录患者临床信息,分析急性胰腺炎的病因及临床特点变化.结果:235例急性胰腺炎患者中,年龄60岁(中青年组)155例,年龄≥60岁(老年组)80例;重症胰腺炎55例,非重症胰腺炎180例.中青年组与老年组急性胰腺炎均以胆源性、暴饮暴食及高脂血症最常见;中青年组胆源性、酒精源性、暴饮暴食比例及C-反应蛋白水平明显高于老年组,而老年组高脂血症性急性胰腺炎比例高于中青年组,差异有统计学意义(P0.05).非重症组以胆源性急性胰腺炎发生率最高,而重症以高脂血症急性胰腺炎发生率最高;重症组胆源性、酒精源性、高脂血症、腹痛、恶心呕吐比例及C-反应蛋白、血淀粉酶、降钙素原水平明显高于非重症组,差异有统计学意义(P0.05).结论:近4年急性胰腺炎发病仍以胆源性为主,不同年龄段急性胰腺炎病因有差异,高脂血症更容易发生重症急性胰腺炎.     

急性高脂血症性胰腺炎临床分析

急性胰腺炎是临床常见的急腹症。高脂血症引起的急性胰腺炎被称为急性高脂血症性胰腺炎,其症状重、并发症多、易反复发作。2003年11月-2007年11月,我们对急性高脂血症性胰腺炎患者的临床特点及治疗进行了分析,旨在加强对该病的认识,提高诊治水平。     

Management of acute severe hyperlipidemic pancreatitis

BACKGROUND/AIM: Hypertriglyceridemia is rare and can provoke acute severe hyperlipidemic pancreatitis when triglyceride levels exceed 11.3 mmol/l. In 10 patients we evaluated the therapeutic guidelines for severe hyperlipidemic pancreatitis. METHODS: Ten patients (8 men and 2 women) were admitted to the intensive care unit with a diagnosis of acute severe hyperlipidemic pancreatitis. They underwent standard treatment. Heparin, insulin and antihyperlipidemic drugs were used to lower the triglyceride levels. The patients underwent plasmapheresis within 48 h of admission, and fat-free parenteral nutrition was used. Two of the patients underwent surgery because of infection of necrotic segments. RESULTS: Standard treatment was essential for all the patients but plasmapheresis was the procedure that lowered the triglyceride and lipid levels in all cases. It improved abdominal pain, clinical state, and signs and symptoms of the disease. Two patients underwent surgery due to infection of the necrotic segments and one of them died. Follow-up lasted 4-54 months with no recurrences of pancreatitis. CONCLUSION: Our study shows that standard treatment is essential, but plasmapheresis successfully lowered lipid levels with no complications and relieved the patients from the symptoms in the acute phase of the disease. Hyperlipidemic pancreatitis should initially be treated conservatively. Plasmapheresis is a method that has lately been used successfully for hyperlipidemic pancreatitis. It seems that all therapeutic measures should be applied as early as possible, within the first 48 h.     

Plasmapheresis in the management of acute severe hyperlipidemic pancreatitis: report of 5 cases.

BACKGROUND/AIM: Hyperlipidemic pancreatitis is an acute and potentially life-threatening complication of hypertriglyceridemia that can be provoked when triglyceride levels (TGL) exceed 11.3 mmol/l (1,000 mg/dl). Except for standard symptomatic treatment, plasmapheresis has been performed to rapidly reduce TGL and chylomicron levels in the blood. In 5 patients with hyperlipidemic pancreatitis, treatment with plasmapheresis was evaluated. METHODS: Five male patients who suffered from acute pancreatitis with severe primary hyperlipidemia were studied. In addition to the standard treatment, they were treated with plasmapheresis. RESULTS: Plasma exchange lowered the lipid level and TGLs in all cases. It also improved abdominal pain, the clinical state of the patients, and signs and symptoms of the disease. Complications of treatment were not encountered, none of the patients died and only 1 patient underwent surgery. Follow-up of the patients lasted 4-28 months, and recurrence of pancreatitis was not noted. CONCLUSION: Our study showed that plasmapheresis was successfully applied in patients with hyperlipidemic pancreatitis, especially to improve the acute phase of the disease.     

妊娠合并高脂血症性胰腺炎治疗进展

妊娠合并急性胰腺炎是妊娠期严重的并发症,其中高脂血症性胰腺炎近年在妊娠合并急性胰腺炎病因中所占比率逐年增加.近年统计高脂血症所占比率高达妊娠合并急性胰腺炎的56%,而且妊娠合并高脂血症性胰腺炎为重症胰腺炎的主要原因,多见于妊娠中晚期,易反复发作,病情凶险,孕产妇病死率及围生儿病死率达20%-50%,严重威胁着孕产妇的身体健康,也殃及胎儿的生命安全.目前临床上致力于研究降低此病的发病率、孕妇与胎儿的死亡率以及避免婴儿的畸形,本文就有关妊娠合并高脂血症性胰腺炎治疗方面的现状与进展作一综述.     

Therapeutic plasma exchange in patients with hyperlipidemic pancreatitis

AIM:To clarify the effectiveness of plasma exchange bycomparing the mortality and morbidity before and afterthe intervention of plasma exchange.METHODS:Plasma exchange has been available as anoptional therapy for hyperlipidemic pancreatitis since August1999 in our hospital.The patients were assorted into 2 groups(group Ⅰ:before August 1999 and group Ⅱ:after August1999).Group Ⅰ consisted of 34 patients(before theavailability of plasma exchange).Group Ⅱ consisted of60 patients(after the availability of plasma exchange).Twenty patients in group Ⅱ received plasma exchange aftergiving their consent.The mortality and morbidity werecompared between group Ⅰ and group Ⅱ.Furthermore,the patients with severe hyperlipidemic pancreatitis(Ranson's score≥3)were analyzed separately.Themortality and morbidity were also compared between thosereceiving plasma exchange(group A)and those who didnot receive plasma exchange(group B).RESULTS:There was no statistical difference in themortality,systemic and local complications between groupⅠ and group Ⅱ.When the patients with severe hyperlipidemicpancreatitis were analyzed separately,there was nostatistical difference between group A and group B.CONCLUSION:Plasma exchange can not ameliorate theoverall mortality or morbidity of hyperlipidemic pancreatitis.The time of plasma exchange might be the critical point.Ifpatients with hyperlipidemic pancreatitis can receive plasmaexchange as soon as possible,better result may be predicted.Further study with more cases is needed to clarify the roleof plasma exchange in the treatment of hyperlipidemicpancreatitis.     

Therapeutic plasma exchange in patients with hyperlipidemic pancreatitis

AIM: To clarify the effectiveness of plasma exchange by comparing the mortality and morbidity before and after the intervention of plasma exchange.METHODS: Plasma exchange has been available as an optional therapy for hyperlipidemic pancreatitis since August 1999 in our hospital. The patients were assorted into 2 groups (group I: before August 1999 and group II: after August1999). Group I consisted of 34 patients (before the availability of plasma exchange). Group II consisted of 60 patients (after the availability of plasma exchange).Twenty patients in group II received plasma exchange after giving their consent. The mortality and morbidity were compared between group I and group II. Furthermore,the patients with severe hyperlipidemic pancreatitis (Ranson‘s score≥3) were analyzed separately. The mortality and morbidity were also compared between those receiving plasma exchange (group A) and those who did not receive plasma exchange (group B).RESULTS: There was no statistical difference in the mortality, systemic and local complications between group I and group II. When the patients with severe hyperlipidemic pancreatitis were analyzed separately, there was no statistical difference between group A and group B.CONCLUSION: Plasma exchange can not ameliorate the overall mortality or morbidity of hyperlipidemic pancreatitis.The time of plasma exchange might be the critical point. If patients with hyperlipidemic pancreatitis can receive plasma exchange as soon as possible, better result may be predicted.Further study with more cases is needed to clarify the role of plasma exchange in the treatment of hyperlipidemic pancreatitis.     

高脂血症、微循环障碍与急性胰腺炎关系的探讨

目的探讨高脂血症（特别是高三酰甘油血症）、微循环障碍与急性胰腺炎严重度的关系,加强对高脂血症性急性胰腺炎（hyperlpidemic acute pancreatitis,HLAP）的认识。方法将我院2006年1月～2009年8月收治的143例急性胰腺炎患者,按临床表现分为轻型急性胰腺炎（mild acute pancreatitis,MAP）82例,占57.34%,重症急性胰腺炎（severe acute pancreatitis,SAP）61例,占42.66%;按病因分为脂源性胰腺炎（hyperlipemia acute pancreatitis,HLAP）42例,占29.37%,非脂源性胰腺炎（non-hyperlipemia a-cute pancreatitis）101例,占70.63%。探讨高脂血症与MAP和SAP的关系。结果脂源性胰腺炎与非脂源性胰腺炎组比较,全血黏度（高切）、全血黏度（低切）、CRP差异有统计学意义（P〈0.001）,脂源性胰腺炎组并发症发生率较高且严重。结论故高三酰甘油（TG）血症、微循环障碍是AP持续和加剧损害的因素。     

Hypertriglyceridemic acute pancreatitis in a patient with Sheehan''''s syndrome

BACKGROUND: There is no report on case of severe acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome. METHODS: A 32-year-old female patient was diagnosed as having acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome, and treated with diet and lipidlowering agents in early stage. RESULTS: Abdominal pain and fever of the patient resolved within a few days. She was subjected to diet and oral lipid-lowering therapy on the 4th day after admission. The disease did not recur during the follow-up for more than one year. CONCLUSIONS: Estrogen replacement therapy should be prescribed for Sheehan's syndrome. The serum level of triglyceride should be monitored and treatment should be given to prevent severe acute pancreatitis. Lipid-lowering therapy in early stage is the key step towards a complete recovery.     

Severe acute pancreatitis associated with hyperlipidemia: report of two cases and review of the literature in Japan

Two cases of severe acute pancreatitis associated with type V hyperlipoproteinemia are reported. A 39-year-old obese woman was hospitalized with continuous severe abdominal pain. The diagnosis was made on the day of admission to our hospital, and treatment using continuous regional arterial infusion of a protease inhibitor and an antibiotic was performed with good results. The other patient was a 35 year-old woman in the 35th week of pregnancy, and a diagnosis of gestational hyperlipidemic pancreatitis was made on the day of onset. She was treated supportively using intravenous hyperalimentation, protease inhibitors, and antibiotics. She recovered from the acute pancreatitis and delivered a healthy term infant. It is difficult to diagnose acute pancreatitis in patients with type V hyperlipoproteinemia, because even when serum amylase levels are high, the value is reduced by high serum triglycerides. Early diagnosis was achieved in both of the present cases, and early intensive therapy was performed, which may be of the utmost importance in saving the life of a patient.     

高脂血症急性胰腺炎15例临床分析

目的 探讨高脂血症急性胰腺炎(HLAP)的临床特征及治疗.方法 对15例HLAP患者(HLAP组)资料进行回顾性分析,并与22例非高脂血症胰腺炎患者进行对照研究,比较实验室指标、病情严重程度和临床转归等方面的差异.结果 HLAP组入院时血淀粉酶278±65 u/L,血糖11.9±1.6 mmol/L,血甘油三酯11.0...