急性胰腺炎伴肝损害64例临床分析

目的　探讨急性胰腺炎合并肝损害的发病原因及防治。方法　对诊断明确的急性胰腺炎伴肝损害64例临床资料进行回顾性分析。结果　急性胰腺炎时,伴肝损害较为多见,其病因以胆石症最多(50％)。表现为谷丙转氨酶(ALT)、碱性磷酸酶(ALP)升高和(或)总胆红素(TBIL)升高。通过积极治疗,大多可恢复正常,部分需保肝、降酶治疗后方可正常。结论　急性胰腺炎伴肝损害的病因以胆石症最多见,胆道梗阻压力升高在急性胰腺炎肝损害的发病中占重要地位。同时,应重视不明原因患者胰腺炎伴肝损害的诊断。经治疗原发病,大多肝损害可恢复。肝功能严重异常时,常提示预后不良,需积极保肝、降酶治疗。

Clinical Analysis of Acute Pancreatitis Associated with Liver Injury

Objective To determine the cause and prophylaxis , as well as treatment, of acute pancreatitis associated with liver injury. Methods Retrospective analysis on 64 cases with definit diagnosis of acute pancreatitis associated with liver injury was performed. Results Acute pancreatitis was frequently found to be associated with liver injury. Cholelithiasis was the main cause and took up 50% in proportion. Accordingly , lab tests indicated high levels of ALT and ALP or total bilirubin . Most cases' liver functions could return to normal levels after active treatment, while some others needed further treatment of liver care and lowering ferment level Conclusion Cholelithiasis is the main cause of acute pancreatitis associated with liver injury . Obstructive cholangitis giving rise to high pressure plays a vital role in this process. In addition , to lay stress on those who have no definit diagnosis is necessary. Most patients liver functions can return to normal level by curing original diseases. Active treatment of liver care and lowering ferment is needed when liver function is seriously abnormal, which indicates unfavorable prognosis.