| Objective:By retrospectively analyzing the etiology,recurrence regularity and clinical characteristics of patients with acute recurrent pancreatitis in our hospital,clinical workers can achieve a deeper understanding of acute recurrent pancreatitis and take corresponding measures to reduce the recurrence rate,improve the patient's quality of life and reduce the medical expenses.Methods:Collect the patients diagnosed with acute pancreatitis from the Second Affiliated Hospital of Kunming Medical University between September 2016 to September 2018,and 390 eligible patients were screened.Among them,305 cases were classified as the primary group,and 85 cases were classified as the relapse group.Compare the general information,laboratory indicators,etiological composition,severity rate and main treatment methods after admission between the primary group and relapse group.Results:1.A total of 390 cases of acute pancreatitis were collected.The primary group had 305 cases.The relapse group had 85 cases.The recurrence rate was 21.79%.2.Comparison of general data:The relapse group had 57 males(67.1%)and 28 females(32.9%).There were 203 males(66.6%)and 102 females(33.4%)in the primary group.Two groups of gender had no statistical significant difference(P>0.05).The mean BMI of the primary group was 24.58±4.10kg/m2,and that of the relapse group was 24.59±3.93kg/m2.The mean BMI between the two groups had no statistically significant difference.There were 48 young patients(56.5%),31 middle-aged patients(36.5%)and 6 elderly patients(7.1%)in the relapse group.There were 133 young patients(43.6%),109 middle-aged patients(35.7%)and 63 elderly patients(20.7%)in the primary group.The youth group accounted for a higher proportion in the relapse group.In the primary group,the elderly group accounted for a higher proportion.The difference in age distribution between the two groups was statistically significant(P<0.05).3.Comparison of etiological classification:There were 85 patients in the relapse group:20 cases of biliary(23.5%),6 cases of alcoholic(7.1%),21 cases of hyperlipidemia(24.7%),23 cases of compound type(27.1%),9 cases of idiopathic(10.6%),5 cases of anatomic abnormalities(5.9%),including 3 cases of pancreas divisum,1 case of pancreaeticobiliary maljunction,1 case of congenital choledochal cyst,1 case(1.2%)of other etiology.The primary group:175 cases of biliary(57.4%),11 cases of alcoholic(3.6%),21 cases of hyperlipidemia(6.9%),53 cases of compound type(17.4%),5 cases of anatomic abnormalities(1.6%),including 2 cases of juxtapapillary duodenal diverticulum,2 cases of pancreatic divisum,1 case of congenital choledochal cyst.There were 31 cases of idiopathic acute pancreatitis(10.2%)and 9 cases of other etiology(3.0%)in the primary group.The proportion of biliary was higher in the primary group than that in the relapse group.Hyperlipidemia,compound type and anatomical abnormalities accounted for a higher proportion of the relapsed group than that in the primary group.There was a statistically significant difference in the etiology classification between the two groups(P<0.05).4.Risk factors for relapse of pancreatitis:Logistic regression analysis:hyperlipidemia(OR=2.055,95%CI=2.055-10.408,P<0.001),compound type(OR=1.648,95%CI=1.648-7.629,P=0.001)and anatomic abnormalities(OR=1.196,95%CI=1.196-17.881,P=0.026)were the risk factors for relapse of pancreatitis.5.Relationship between recurrence interval and gender:In the relapse group,63 cases of recurrence interval were more than 6 months,including 46 cases of males(73%)and 17 cases of females(27%).There were 22 cases with recurrence interval within 6 months,including 11 cases of males(50%)and 11 cases of females.The difference between recurrence interval and gender was statistically significant(P<0.05).6.Relationship between etiology and number of relapses in the relapse group:There(?)difference in the number of relapses amone biliary and compound type(P<0.05),and there was no statistically significant difference between the remaining etiology and the number of relapses(P>0.05).7.The proportion of severe acute pancreatitis:There were 20 cases of SAP in the relapse group,severe rate was 23.5%,including 4 cases of biliary(25.0%),1 case of idiopathic(5.0%),6 cases of compound type(30.0%),1 case of alcoholic(5.0%),2 cases of anatomic abnormalities(10.0%)and 5 cases of hyperlipidemia(25.0%).There were 44 cases of SAP in the primary group,severe rate was 14.4%,including 24 cases of biliary(54.5%),3 cases of idiopathic(6.8%),3 cases of hyperlipidemia(6.8%),1 case of alcoholic(2.3%),11 cases of compound type(25%)and 2 cases of anatomic abnormalities(4.5%).There was a statistically significant difference in the severe rate between the primary group and the relapsed group(P<0.05).The proportion of the severe acute biliary pancreatitis in the primary group was higher than that in the relapse group and the proportion of the severe acute hyperlipidemia pancreatitis in relapse group was higher than that in the primary group.The difference between etiology and severity was statistically significant(P<0.05).8.Treatment:In the relapse group:Cholecystectomy or therapeutic endoscopy were performed in 5 cases(25%)and conservative treatment were performed in 15 cases(75%).In the primary group:Cholecystectomy or therapeutic endoscopy were performed in 80 cases(48.6%)and 95 cases(51.4%)with conservative treatment.The difference between the two groups was statistically significant(P<0.05).Conclusion:1.Biliary-hyperlipidemia compound type,hyperlipidemia and abnormal pancreaticobiliary anatomy were the common causes of recurrent pancreatitis.Among the compound type,biliary-hyperlipidemia type was the most common type.2.Compound type tended to recur multiple times.Recurrent hyperlipidemia pancreatitis was more likely to develop into severe pancreatitis.3.Acute recurrent pancreatitis mostly recured after half a year,mainly in young men.4.In the first episode of pancreatitis,actively seeking out the etiology and treating the etiology can effectively prevent the recurrence of pancreatitis. |
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