| Objective: The purpose of this study to retrospectively analyzed the First Hospital of Lanzhou University from Sep 2006 to Dec 2016,admitted to our hospital include the Second Dept of General Surgery,the fifth Dept of General Surgery,the VIP Dept of General Surgery patients who were with complete case information AP,univariate and multivariate statistics Analysis,to explore the recurrence of recurrent acute pancreatitis risk factors in order to guide clinical work,for risk factors to take positive interventions to prevent and reduce the number of attacks of acute pancreatitis.Methods: Retrospective analysis of the First Hospital of Lanzhou University from Sept 2006 to Dec 2016,admitted to our hospital include the Second Dept of General Surgery,the fifth Dept of General Surgery,the VIP Dept of General Surgery patients who were with complete information on a total of 962 AP inpatients.All patients were eligible for inclusion and exclusion criteria.According to the follow-up results and re-admission treatment,821 patients were divided into single-dose group and 141 relapsed patients.General data and risk factors including name,sex,age,BMI,biliary system history(acute and chronic cholangitis,gallstones,common bile duct stones,common bile duct stenosis,history of cholecystectomy),alcohol consumption history,ALT,AST,TBIL,DBIL,ALD,AST,ALT,AST,AST,ALT,AST,Serum triglyceride,blood glucose,calcium levels,C-reactive protein,homocysteine;imaging studies,including X-ray,abdominal ultrasound,CT,MRI,MRCP and so on.The above data were processed,and all data were analyzed by statistical method.Result:(1)Among the 141 cases of recurrent group,there were 88 males,53 females,17 menopause and 36 without menopause,with an average age of 41.27 years,821 cases in the single group,461 men and 360 women,175 cases of menopause,185 cases without menopause,average age of 46 years,the average age in the recurrent group was lower than that of the single group,and the difference of menopause in the two group was statistically significant(P<0.05)There was no significant difference in sex between the two groups(P>0.05).Among the 141 cases of recurrent group,88 men and 53 women were male,the average age of men was 38.27 years,the average ageof women was 46.2 years old.The males in the recurrent group were more than those of the women,and the male age was lower than the female age.There was a significant difference in sex and age between the two groups(P<0.05).The recurrence rate of RAP was 14.7%,and the number of recurrences was 1~12 times,averaging 2.26 times.There were 74 cases(52.5%)recurred 1times,27 cases(19.1%)recurred 2 times,17 cases(12.1%)recurred 3 times,and 23 cases(4)recurred 4 times or more.The proportion of men in the relapse group was more than that of the female.There were 68 recurrences in June and 73 cases recurred in June.The recurrence interval was statistically significant(P<0.05),and the recurrence within June and above was more than that of women.(2)The recurrence group had statistically significant differences in AST,ALT,TBIL,DBIL,and TG compared with the solitary group(P<0.05).Of the 141 patients in the recurrent group,60 were fatty liver patients,including 41 males(68.3%)and 19 females(31.7%).Of the821 individuals in the single-onset group,244 were fatty liver patients,including 171 males(70.1%)and 73 females(29.9%).The total difference between the two groups was statistically significant(P<0.05).In the recurrent group,the bile duct diameter was 4-20 mm,the average diameter was 6.39 mm,and the bile duct diameter was 3 to 78 mm in the single-birth group,and the average diameter was 7.49 mm.The biliary diameters of the recurrent group and the single-disease group were statistically significant(P<0.05).The alcoholic recurrence group had a biliary diameter of 4-9 mm,an average diameter of 4.9 mm,a bile duct diameter of 4-12 mm in the single-onset group,and an average diameter of 5.15 mm.There was no statistically significant difference in bile duct diameter between the two groups(P>0.05).RAP performed ERCP in 41 cases,35 cases(85.4%)recurred 2 years before surgery,and 6 cases(14.6%)recurred after surgery.(3)Cholecystectomy was performed in 20 cases,18 cases(90%)recurred 2 years before operation,and 2 cases(10%)recurred after operation.Conservative treatment was performed in 80 cases,69 cases(86.3%)recurred 2 years before treatment,and 55 cases(68.8%)recurred after treatment.Logistic analysis of the causes and causes of recurrent and single onset groups showed that biliary,hyperlipidemia,alcohol and bile duct anatomic abnormalities were statistically significant(P<0.05),which were the risk factors for repeated episodes of RAP.Conclusion: The etiology of RAP was biliary,alcoholic,hyperlipidemia,and abnormal anatomy of the biliary and pancreatic ducts.Mainly male,the majority of recurrence within six months,2years of treatment within the cause,can reduce the recurrence rate.Alcoholic RAP is mainly composed of middle-aged and young men,alcoholic AP and RAP,and the diameter of biliary tract is more than 5mm.RAP,AP and fatty liver are closely related.Cholecystectomy can reduce the recurrence rate of AP.The ERCP caused by choledocholithiasis is the first choice for ERCP.ERCP can identify the causes of most RAP,and through ERCP treatment,it can reduce the recurrencerate of RAP. |
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