| Objective: This paper summarises the etiology,clinical characteristics(gender,age,summarize the recurrence frequency and time interval,laboratory index,and so on)and the methods of diagnosis and treatment options of our hospital patients with acute recurrent pancreatitis,the clinical workers will have a more profound understanding of ARP,so as to guide the clinical early intervention,identify and remove the cause.Finally,improve the cure rate,reduce the recurrence rate?complications and mortality in patients with pancreatitis,reduce the pain of patients,improve the prognosis.The affiliated yijishan Hospital of Wangnan Medical College.Methods: Collecting the complete clinical data of patients with acute pancreatitis(394 cases)of the affiliated yijishan Hospital of Wangnan Medical College from January 2015 to May 2016,There were 86 patients with recurrent pancreatitis,we called Relapse Group(RG),The rest belongs to Primary Group(PG).Make a comparative analysis of the two groups regard of the possible pathogenic factors and clinical characteristics,As well as the early diagnosis and the choice of treatment of ARP.Results: In our study,a total of 396 patients with acute pancreatitis were enrolled,of whom,86 were ARP.(1)General data gender comparison:the PG have 308 patients(78.2%),156 male(50.6%),152 female(49.4%);the RG have 86 patients(21.8%),43 male(50.0%),43 female(50.0%),two groups of gender differences has no statistical significance(p> 0.05).(2)General data age comparison: The average age of PG was 55.955± 16.166 years old,the RG was 53.826±16.919 years old,two groups of average age differences has no statistical significance(p> 0.05).(3)Recurrence comparison: relapsed once has 62 patients(72.1%),30 male(48.4%),32 female(51.6%),relapse more than 1 times has 24 patients(27.9%),13 male(54.2%),11 female(45.8%),recurrence comparison of gender differences has no statistical significance(p> 0.05).(4)Recurrence interval comparison: Recurrence interval is less than or equal to 6 months has 59 patients(68.6%),25 male(42.4%),34 female(57.6%),recurrence interval greater than 6 months has 27 patients(31.4%),18 male(66.7%),9 female(33.3%),Recurrence interval comparison of gender differences has statistical significance(p<0.05).(5)Possible pathogenic factors comparison:In the PG,there were 208 patients caused by biliary factors(67.5%),35 by hyperlipidemia factors(11.4%),30 by alcoholic factors(9.7%)and the other factors has 35 patients(11.4%);in the RG,the biliary,hyperlipidemia,alcoholic and other factors were has 50(58.1%),19(22.1%),8(9.3%)and 9 patients(10.5%),respectively.The first three pathogenic factors of the two groups were biliary(p> 0.05),hyperlipidemia(p<0.05),alcoholic(p> 0.05),so the hyperlipidemia factors of the two groups differences has statistical significance,and is a high risk factor for recurrence of pancreatitis;In the RG,there were 19 patients of SAP,13 patients among them were caused by biliary factors,and in 67 patients of MAP,37 patients caused by biliary factors,the comparison of biliary factors and severity of pancreatitis has no statistical significance(p> 0.05).(6)Comparison of laboratory indexes:The average leukocytes count on admission of PG is 11.485±4.798(×109/L),RG is 11.038±3.764(×109/L),through compare,there is no statistical significance(p> 0.05);The average blood calcium on admission of PG is 2.069±0.258(mmol/L),RG is 2.122±0.233(mmol/L),the comparison of the two groups has no statistical significance(p> 0.05).The mean triglyceride on admission of PG is 1.448±1.426(mmol/L),RG is 1.402±1.291(mmol/L),through compare,there is no statistical significance(p> 0.05).(7)Diagnosis and treatment:Most ARP patients can be diagnosis by abdominal ultrasonography,MRCP,endoscopic ultrasonography,ERCP etc.In our study,there were 3 cases without identified cause of AP in the first attack,after relapsed once or more,they diagnosed as small calculus of common bile duct,pancreas divisum,SOD by ERCP,we also have one patient recurrent pancreatitis due to gallstone,finally was diagnosed as gallbladder cancer by LC;In our hospital,treatment includes comprehensive medical therapy,endoscopic minimally invasive therapy and surgical treatment,etc.Conclusion: 1?The first three pathogenic factors of acute recurrent pancreatitis in our hospital were biliary,hyperlipidemia,alcoholic,and the hyperlipidemia is a high risk factor for recurrence of pancreatitis;2?Endoscopic minimally invasive treatment plays an important role in the diagnosis of the disease,early intervention and prevention of recurrence,especially in biliary pancreatitis and idiopathic pancreatitis,Such as ERCP,EST,biliary and pancreatic duct stent implantation,etc.which is worth to be spread;3 ? This study have found the patients in the RG often have a relapse within half a year,especially the female patients?... |
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