乙型肝炎肝硬化合并急性胰腺炎的临床分析

目的 通过对乙型肝炎肝硬化合并急性胰腺炎的病例进行分析，总结其临床特点及诊治。方法 收集诊断明确的肝炎肝硬化合并急性胰腺炎患者16例，采用回顾统计分析的方法，分别从临床表现、实验室检查、治疗及预后等方面进行总结分析。结果 肝炎肝硬化合并急性胰腺炎时均有不同程度的上腹部疼痛及压痛，但恶心、呕吐、放射痛、腹肌紧张及发热均不常见；B超及CT检查显示胰腺均有相应改变，血清淀粉酶及白细胞增高不多见，中性粒细胞比例均不同程度增高；手术治疗患者均死亡；胰腺炎易反复发作且肝脏损害进一步加重。结论 肝炎肝硬化合并急性胰腺炎临床表现不典型，应综合症状、体征及实验室检查及时做出诊断；应以内科综合治疗为主，且患者病情重，预后差。

Clinical Analysis of Patients With HBV Liver Cirrhosis Concomitant With Acute Pancreatitis

Objective To explore the clinical feature diagnosis and therapy of 16 patients with HBV liver cirrhosis concomitant with acute pancreatitis. Methods Retrospective analysis of the clinical data including symptoms and signs, laboratory findings, therapy, progress of the illness and prognosis. Results All patients had abdominal pain and tenderness pain to some degree, changes of pancreas ultrasonogram and CT were found in all patients. Nausea and vomiting, radiating pain, muscle guarding, fever and high level of serum amylase and white blood cells were seldom found. The ratio of neutrocyte and white blood cells was high in all patients. All patients adopted surgical therapy died. Pancreatitis often relapsed and damage of liver was severe. Conclusions The clinical manifestations of liver cirrhosis concomitant with acute pancreatitis are atypical. It is necessary to combine with the symptoms, signs and laboratory finds for making a right diagnosis and employing the non - surgical treatment. Patients with that illness have poor progress and prognosis.