小儿急性胰腺炎65例临床特点及诊治分析

目的 探讨小儿急性胰腺炎的可能病因及临床特点.方法 回顾分析65例急性胰腺炎患儿资料,分析其临床表现、辅助检查以及诊疗情况.结果 诱发疾病的因素及相对的病例数分别为:特发性17例(26.2％);饮食因素14例(21.5％);胆道因素10例(15.4％);感染因素10例(15.4％);肥胖因素12例(18.5％);其他因素2例(3％).入院时轻度胰腺炎患儿血中C反应蛋白(CRP)值要比中重度胰腺炎低(轻度胰腺炎为12.87 ± 1.02,中重度胰腺炎为25 ± 2.44,P=0.002).诊断为轻度胰腺炎58例(89％),中重度胰腺炎7例(11％).65例患儿均予以非手术治疗,其中61例治愈出院,4例好转.随访53例,期间2例出现胰腺假性囊肿,经保守治疗后痊愈,余无其他并发症.结论 急性胰腺炎患儿中,特发性因素约占三分之一,肥胖因素不可忽视.小儿急性胰腺炎症状不尽典型,如能及时诊断,保守治疗,预后良好.

Clinical features and treatment analysis of 65 cases of acute pancreatitis in children

Objective To explore the pathogeny of acute pancreatitis, and the clinical diagnosis and treatment in children. Methods The clinical data of 65 children with acute pancreatitis were retrospectively studied to analyse the clinical characteristics, auxiliary exami-nation and treatment situation. Results The related causes were idiopathic factors in 17 cases ( 26. 2％); dietary factors in 14 cases (21. 5％);biliary factors in 10 cases(15. 4％);infection factors in 10(15. 4％);obesity factors in 12 cases(18. 5％), and other factors in 2 cases(3％). Patients with moderate and severe pancreatitis had significantly higher serum concentrations of c-reactive protein than those with mild pancreatitis(mild:12. 87 ± 1. 02, severe:25 ± 2. 44, P=0. 002). Mild pancreatitis was diagnosed in 58 cases (89％);moderate and severe in 7 cases (11％). All patients were treated conservatively;61 cases were cured and discharged, 4 cases improved, 53 cases were followed up;pancreatic pseudocyst occurred in 2 cases, recovered after conservative treatment, and other cases had no other complica-tions. Conclusion Among acute pancreatitis in children diagnosed in our hospital, idiopathic factors almost account for a third, and obesity factors cannot be ignored. Acute pancreatitis in children has atypical symptoms, and if it is diagnosed in time and treated conservatively, the prognosis is good.