急性胰腺炎复发的病因及处理

目的：探讨急性胰腺炎病人出院后复发的临床经过、病因学诊断和治疗，以及如何进一步提高急性胰腺炎的诊治水平。方法：分析1997年至2000年间33例急性胰腺炎复发病人的随访资料和临床治疗结果。结果：急性胰腺炎的复发率为12．41％。2次复发26例，3次复发5例，4次和5次复发各1例。33例病人中，出院后1年内复发18例，占复发病例的54．55％；1—3年内复发10例，占30．30％；3年后复发5例，占15．15％。就病因而言，有胆源性胰腺炎17例，酒精性胰腺炎2例，高脂血症3例，胰腺囊性腺癌3例，特发性胰腺炎8例。手术治疗8例，经内镜逆行胰胆管造影术(ERCP)及经内镜括约肌切开术(EST)治疗2例。死亡5例，死亡率15．15％。结论：明确病因是减少复急性胰腺炎复发的基本条件，针对病因的合理治疗是降低急性胰腺炎复发的有效保证。

Etiology amd Managements of Recurrence of Acute Pancreatitis

Objective: To study the etiology and management of recurrence of acute pancreatitis . Methods: The clinical data and the therapeutic results of 33 cases of recurrence of acute pancreatitis admitted from 1997 to 2000 were analyzed. Results: The rate of recurrence was 12.41%(33/266). Of the 33 patients, 26 had two relapses, 5 had three relapses, and two cases each had four or five relapses. Eighteen patients (54.55%) had their recurrence within one year after discharge, 10 (30.30%) after one to three years, and 5 (15.15%) after three years. Etiologically,17 had biliary pancreatitis, 2 alcohol-induced, 3 hyperlipidemic, 3 with pancreatic cystadenocarcinoma, and 8 belonged to idiopathic pancreatitis. Eight patients underwent surgical operation, and 2 patients had ERCP with sphincterotomy (EST). Five patients died (15.15%). Conclusions: It is essential to elucidate the causes of recurrence and treat the cases accordingly in order to decrease the rate of recurrence.