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目的探讨广东地区急性胰腺炎(AP)的临床特点和发病规律。方法总结分析中山大学附属第二医院及广东省人民医院1986-2005年 AP 住院患者共1316例临床资料,并对结果进行统计分析。结果 1986-1990年间病例数占同期内、外科住院总人数的0.19%,1991-1995年间上升为0.36%,1996-2000年间升至0.54%,而2001-2005年间则高达为0.71%。1316例患者中胆源性胰腺炎占60.48%,其余依次为高脂血症胰腺炎、特发性胰腺炎。临床症状以上腹部疼痛为主,伴或不伴腰背部放射痛,多数伴有恶心、呕吐等消化道症状。动态增强 CT 扫描是明确诊断、严重度分级及发现并发症的准确影像学方法。非手术治疗1104例,死亡24例;手术治疗212例,死亡48例。结论 AP 发病例数逐年增多,AP 发病因素多而复杂,胆道疾病仍为主要病因。影像学检查有助于早期诊断及严重度分级,早期治疗可采用中西医结合的非手术疗法,严格掌握手术指征,合理使用内镜技术,均能取得理想的治疗效果。
Objective To investigate the clinical features and pathogenesis of acute pancreatitis (AP) in Guangdong Province. Methods The clinical data of 1316 AP inpatients in the Second Affiliated Hospital of Sun Yat-sen University and Guangdong Provincial People’s Hospital from 1986 to 2005 were summarized and analyzed. Results were statistically analyzed. Results The number of cases between 1986 and 1990 accounted for 0.19% of the total number of surgical inpatients in the same period, from 0.19% in 1991-1995 to 0.54% in 1996-2000 and 0.71% in 2001-2005. Among 1316 patients, biliary pancreatitis accounted for 60.48%, followed by hyperlipidemia pancreatitis and idiopathic pancreatitis. Clinical symptoms of abdominal pain above, with or without low back pain radiated, most with nausea, vomiting and other gastrointestinal symptoms. Dynamic contrast-enhanced computed tomography (CT) is an accurate method of imaging that identifies a diagnosis, ranks the severity, and identifies complications. 1104 cases of non-surgical treatment, 24 died; surgical treatment of 212 cases, 48 died. Conclusion The incidence of AP increased year by year, AP multiple and complex disease factors, biliary disease is still the main cause. Imaging examination can help early diagnosis and severity grading, early treatment can be combined with non-surgical treatment of Chinese and Western medicine, strict surgical indications, rational use of endoscopic techniques, can achieve the desired effect of treatment.