高脂血症性胰腺炎的临床诊断及治疗

目的探讨高脂血症性胰腺炎的临床诊治特点。方法回顾性分析收治的36例高脂血症性胰腺炎的临床资料,并对其临床特点及治疗进行分析。结果高脂血症性胰腺炎的临床症状与其他原因所致胰腺炎相同,但更易发展为重症;半数以上患者血淀粉酶正常或轻度增高;所有患者均有血清脂浊,血清甘油三酯和胆固醇明显增高;早期腹部B超阳性率低而腹部CT或MRI均有阳性发现。对急性胰腺炎除常规治疗措施外,还应针对高血脂使用低分子肝素钠、胰岛素、连续血液净化（CBP）治疗,血脂水平多在4～7天降至5.65mmol/L以下,均顺利恢复,无死亡病例。结论高脂血症性胰腺炎的诊断主要依据血甘油三酯（TG）增高达到标准以及影像学支持,血淀粉酶的临床意义不大。迅速降低血TG水平是高脂血症性胰腺炎早期治疗的关键。

Clinical diagnosis and treatment of pancreatitis complicated with hyperlipemia

Objective To investigate the specialities of diagnosis and treatment of pancreatitis complicated with hyperlipimia.Methods A retrospective analysis was done of the clinical data of 36 cases of pancreatitis complicated with hyperlipemia.Results The clinical symptoms of pancreatitis complicated with hyperlipemia were not different from those of the common pancreatitis.Only it could develop into a more serious plight.The levels of blood serous diastase of half of the cases were normal or only a little over normal.The patients all suffered from lipoidemia,The levels of their TG and T-Ch were raised obviously.The positive rate of abdomen B-ultrasonic examination in early stage was rather low.But CT and MRI examinations were always positive.All the cases were first treated as common pancreatitis routinely.In addition to the above treatment,to fight against hyperlipemia,low molecule heparin sodium,insulinum,and CBP were used.Within 4 to 7 days,the hemolipoid level dropped to 5.65 mmol/L and lower.All patients recovered smoothly without any death.Conclusion The diagnosis of pancreatitis complicated with hyperlipemia depends on the raise of TG level over normal and helped by CP and MRI examinations.Examination of blood serous diastase is not of much use.2.To reduce TG level is the most important procedure to cure pancreatitis complicated with hyperlipemia in its early stage.