摘要
目的探讨急性胰腺炎的临床特点。方法回顾性分析急性胰腺炎患儿106例的病因、诱因、临床表现、实验室及影像学检查、治疗及预后情况,总结急性胰腺炎的临床特点。结果病因以特发性胰腺炎(38例,35.8%)、腮腺炎病毒感染(36例,33.9%)及胆道疾病(16例,15.0%)为主。以腹痛(102例,96.2%)、呕吐(17例,72.6%)、发热(48例,45.3%)为主要症状,以腹部压痛(78例,73.6%)、腹肌紧张(19例,17.9%)、腹胀(11例,10.6%)为主要体征。血清、尿淀粉酶及血清脂肪酶检出率为84.8%(91例)、58.5%(62例)和55.0%(6例)。超声及CT检查阳性率为55例(51.9%)和30例(81.0%)。5例行内镜逆行胆囊-胰腺造影术(ERCP)或磁共振胰胆管造影(MRCP),能较清晰显示胰胆管。本组以非手术治疗为主,手术治疗仅6例。痊愈65例,好转40例,死亡1例。治疗有效率达99%。并胰腺假性囊肿2例。结论儿童急性胰腺炎的病因以特发性胰腺炎及腮腺炎病毒感染为主;腹痛等表现仍为其重要诊断依据;常并胰腺外损害;胰酶检测结合影像学检查有助于其诊断;以非手术治疗为主,及时诊断和对症治疗预后较好;胰腺假性囊肿为其主要并发症。
Objective To understand the clinical features of children with acute pancreatitis. Method Clinical data of 106 in patients in Children＇s Hospital with acute pancreatitis from Juh 1991 to Jan. 2005 were analyzed retrospectively. Results The most frequent etiologic factors of childhood acute pancreatitis were idiopathic（35.8% ）, mumps virus infection（33.9% ）and biliary tract diseases（ 15% ）. Abdominal pain（96.2% ）, vomiting （72.6%）and fever（45.3% ） were the most common clinical symptoms. And the most common signs were abdominal tenderness（73.6% ）, abdominal wall rigidity（ 17.9 % ）and abdominal distention（ 10.6% ）. Multisystem damage usually occurred in childhood acute pancreatitis. Serum amylase, urinary amylase and serum lipase elevated 84.8%, 58.5% and 55% in patients, respectively. Fifty-one percont patients had abnormal ultrasound imaging and 81% had abnormal computed tomographic imaging. In 5 patients who were subjected to endoscopic retrograde cholangiopancreatography（ERCP） and magnetic resonance cholangiopancreatography （MRCP）, the pancreaticobiliary system was visualized clearly. Nonsurgical therapy was done in most patients, only 6 cases received surgical therapy. Sixty - five cases were cured and 40 cases straightened up, only 1 case died. The efficiency rate was 99 %. Pseudocysts occurred in 2 patients. Conclusions Idiopathic pancreatitis and mumps vires infection are the most frequent etiologic factors for childhood acute pancreatitis. Symptoms and signs such as abdominal pain and abdominal tenderness are the important diagnostic bases of childhood acute pancreatitis. Childhood acute pancreatitis was always accompanied by muhisystem damage. Pancreatic enzyme test and radiography test were helpful in the diagnosis of childhood acute pancreatitis. Nonsurgical therapy is the leading therapeutic means of childhood acute pancreatitis. Timely diagnosis and allopathy help to improve the prognosis of childhood acute pancreatitis. Pseudocyst is the primary complication of childhood acute pancreatitis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2006年第13期845-846,共2页
Journal of Applied Clinical Pediatrics
关键词
胰腺炎
急性
病因
临床特征
预后
儿童
acute pancreatitis
etiology
clinical feature
prognosis
child
