重症肝炎并发急性胰腺炎临床特点及预后的探讨

目的探讨分析重型肝炎并发急性胰腺炎的临床特点及预后因素。方法回顾性分析我院2004年1月至2011年6月重症肝炎120例,将60例并发急性胰腺炎的患者分为观察组,其余为对照组,比较两组患者临床症状及特点;在观察组中按照疾病转归分为好转组32例与恶化组28例,分析比较影响疾病预后的相关因素。结果两组患者的临床表现的比较:重度黄疸、剧烈呕吐以观察组中更为多见;实验室检查比较:观察组患者在重度黄疸、剧烈呕吐、淀粉酶急剧升高、TBIL、白细胞急剧升高及白细胞数值均明显高于对照组(P<0.05),具有统计学意义。好转组与恶化组患者在肝炎病毒感染类型,血清TBIL、PTA、MODS个数这些因素上差异明显(P<0.05),具有统计学意义。结论重型肝炎合并急性胰腺炎的病死率高,其预后与多种因素相关,早期明确诊断、及时治疗对改善其预后有重要意义。

Clinical Features and Prognosis of Severe Hepatitis Complicated with Acute Pancreatitis

Objective To investigate and analyze the clinical features and prognostic factors of severe hepatitis complicated with acute pancreatitis. Methods 120 cases of severe viral hepatitis in our hospital from January 2004 to June 2011 were divided into observation group (60 cases of severe hepatitis complicated by acute pancreatitis) and control group (other 60 cases) and analyzed retrospectively; the clinical symptoms and features were analyzed. The cases in observation group were divided into improved group (32 cases) and deteriorated group (28 cases) according to the outcome; the related factors of disease prognosis were analyzed and compared. Results The cases of severe jaundice and hyperemesis in observation group were more common; laboratory comparison: severe jaundice, hyperemesis, amylase increased sharply, TBIL, white cells increased rapidly, and white blood cell values in observation group were significantly higher than those in control group with statistical significance(P<0.05 ) . The differences of hepatitis virus infection types, serum TBIL, PTA, MODS number in improved group and deteriorated group had statistical significance (P<0.05). Conclusions Severe hepatitis complicated with acute pancreatitis has high mortality rate, and its prognosis is related to many factors; early clear diagnosis and prompt treatment are important to improve the prognosis.