本文選題：急性胰腺炎　切入點：復發(fā)　出處：《重慶醫(yī)科大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:分析復發(fā)性急性胰腺炎(RAP)的臨床特點、病因及其內鏡診治情況,評估內鏡診治在該病中的診療價值。方法:選擇我院開展ERCP診治后自2013年1月至2015年10月期間住院治療的急性胰腺炎患者,根據隨訪后的結果按照是否復發(fā)分為單發(fā)組和復發(fā)組兩組。分析兩組的臨床特征及內鏡診治情況。結果:入組1042例AP患者,單發(fā)組781例,占總的急性胰腺炎的比率為74.95%;復發(fā)組261例,占25.05%。兩組年齡、SAP比例無顯著差異(P0.05),而性別(P=0.003)、胰腺假性囊腫所占比例(P=0.039)比較有顯著差異;復發(fā)性急性胰腺炎距初次發(fā)病半年內復發(fā)率最高(127例,占48.66%)。Logistic回歸分析:膽源性(OR1.812;95%CI 1.311~2.506)、高脂血癥(OR 2.162;95%CI 1.446~3.233)、胰膽管解剖異常因素(OR 2.712;95%CI 1.397~5.263)是急性胰腺炎反復發(fā)作的危險因素。在不明病因的RAP患者中,有14例患者行超聲內鏡檢查,病因診斷陽性率71.43%(10/14);35例行ERCP檢查,病因診斷陽性率82.85%(29/35)。共58例RAP患者行ERCP治療,治療后總緩解率達87.5%。結論:膽源性、高脂血癥及胰膽管畸形因素是AP復發(fā)的危險因素;內鏡治療能顯著降低RAP的復發(fā)率,是對RAP有重要價值的診斷和治療手段。
[Abstract]:Objective: to analyze the clinical features, etiology and endoscopic diagnosis and treatment of recurrent acute pancreatitis (rapp). Methods: to evaluate the value of endoscopic diagnosis and treatment in the diagnosis and treatment of the disease. Methods: select the patients with acute pancreatitis who were hospitalized from January 2013 to October 2015 after ERCP treatment in our hospital. According to the results of follow-up, the patients were divided into two groups: single group and recurrent group. The clinical characteristics, endoscopic diagnosis and treatment of the two groups were analyzed. Results: 1042 cases of AP were included in the study, and 781 cases in the single group. The ratio of acute pancreatitis to total acute pancreatitis was 74.95%, the recurrence group was 261 cases (25.05%). There was no significant difference in the ratio of SAP between the two groups (P 0.05), but there was a significant difference between the two groups in the proportion of P0. 003 and pseudocyst of pancreas (P < 0. 039). The recurrence rate of recurrent acute pancreatitis was the highest in 127 cases within half a year from the first onset. In 48.66%).Logistic regression analysis, OR 1.81295 CI 1.3112.506, OR 2.16295 CI 1.4463.233, OR 2.71295 CI 1.3975.263) were the risk factors of recurrent acute pancreatitis. In 14 RAP patients with unknown etiology, endoscopic ultrasonography was performed. The positive rate of etiological diagnosis was 71.43 / 10 / 14 / 35 ERCP, and the positive rate of etiological diagnosis was 82.85 / 29 / 35. 58 cases of RAP were treated with ERCP, and the total remission rate was 87.5%. Conclusion: the risk factors of AP recurrence are biliary origin, hyperlipidemia and pancreaticobiliary malformation. Endoscopic therapy can significantly reduce the recurrence rate of RAP and is an important diagnostic and therapeutic method for RAP.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R576

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本文編號：1645132