酒精性急性胰腺炎并发肝功能损害36例临床分析

目的：探讨酒精性急性胰腺炎（alcoholicacutepancreatitis，AAP）并发肝损害的临床特点。方法：2000～2005年我院收治的急性胰腺炎病人中有78例并发肝功能损害，根据发病前12～48h内有无大量饮酒分为两组：酒精性AP组（观察组）36例和非酒精性AP组（对照组）42例。两组患者除给予包括禁食、胃肠减压、肠道外营养、抗感染等常规支持治疗外，均另予以还原型谷光甘肽、门冬氨酸钾镁或甘利欣静脉滴注等护肝治疗，并观察两组肝功能指标异常情况。结果：观察组重症胰腺炎发生率显著高于对照组（P〈0．05）；观察组的谷丙转氨酶、谷草转氨酶水平均显著高于对照组（P均〈0.05）。结论：AAP患者肝功能损害更为严重，在临床工作中，对AAP要警惕其发展成重症急性胰腺炎，积极采取各种综合方法进行处理，尽量减少发生不良后果。

Clinical Analyses of Acute Alcoholic Pancreatitis Complicated by Liver Function Damage

Objective:To investigate the liver function damage in patients with acute alcoholic pancreatitis(AAP).Methods: Seventy-eight patients with acute pancreatitis(AP) complicated by liver function damage(from 2000 to 2005) were grouped according to premorbid heavy drinking as observation group(36 cases) and control group(42 cases).All patients were given drugs protecting liver function by intravenous infusing glutathione,potassium magnesium aspartate or glycyrrhizin in addition to conventional therapy including fasting,gastrointestinal decompression,parenteral nutrition,antibiotics.The markers of liver function of the two groups were compared and analyze.Results:The rate of SAP in observation group was significantly higher than those in control group(P<0.05).The concentrations of alanine aminotransferase and aspartate aminotransferase in observation group were still significantly higher than those in control group after 4 weeks treatment.Conclusion:The liver function was damaged more seriously in patients with AAP.In clinical work,we must guard against its SAP develop and adopt an integrated approach to minimize the occurrence of adverse effects.