Analysis Of Clinical Characteristics Of 90 Children With Acute Pancreatitis

Objective:To explore the clinical characteristics and related risk factors of acute pancreatitis(AP),acute recurrent pancreatitis(RAP)and severe acute pancreatitis(SAP)in children.Methods:The clinical data of 90 children with acute pancreatitis admitted to the General Hospital of Ningxia Medical University from December 2010 to December 2020 were retrospectively analyzed.The patients were divided into low age group(15-84 months old,n=28 cases),high age group(85-168 months old,n=62 cases)according to age.The children with AP were divided into RAP group(24 cases)and AP group(66 cases)according to whether they recurred.The children with AP were divided into SAP group(15 cases)and AP group(75 cases)according to the severity.Recorded the patient’s sex,age,date of onset,etiology,severity of AP,serum amylase(AMY),serum lipase(LIP),white blood cell(WBC),platelet counts(PLT),lactate dehydrogenase(LDH),serum calcium level,albumin,triglyceride,cholesterol.The etiology of AP(biliary,hyperlipidemic,idiopathic,anatomical abnormalities,etc.),imaging examination results,treatment methods and curative effects,etc.The clinical characteristics and related risk factors of AP,RAP and SAP in children were analyzed by logistic regression analysis.Results:Among the 90 children with AP,the main causes included idiopathic 50cases(55.55%),biliary and pancreatic duct anatomy abnormalities 13 cases(14.44%),biliary origin 11 cases(12.22%),trauma 4 cases(4.44%),ALL 4 cases(4.44%),drugs 3 cases(3.33%),SLE 2 cases(2.22%),viral infection 2 cases(2.22%),and allergic purpura 1 case(1.11%).Compared with the high age group,the low age group has 28 cases,the high age group has 62 cases,and the average age is(109.10 ± 44.529)months;A total of 83.33%(75/90)patients had abdominal pain,35.71%(10/28)patients in the low age group had vomiting symptoms,and 30.65%(19/62)patients in the high age group had vomiting symptoms;The difference was not statistically significant.Univariate analysis showed that there was statistically significant difference in age and abdominal color ultrasound between the two groups(P<0.05).Compared with AP group,RAP group had 24 cases(26.67%)of recurrence in 90 patients with AP,which occurred in 6.63(1.00-11.590 months)after the onset of AP;the age of onset was 109.83 months(24-168 months),with an average of 2.83(2-10)recurrences.The higher causes of recurrence were idiopathic factors(9/24)and pancreatic anatomical abnormalities(7/24).Univariate analysis showed that pancreatic anatomical abnormalities(P=0.040),AP severity(P=0.025)Idiopathic(P=0.038)are a risk factors for the recurrence of AP in children.Multivariate regression analysis of the above significant univariate analysis results showed that pancreatic anatomical abnormalities(OR=4.118 95% CI 1.220-13.894,P=0.023)and AP severity(OR=4.479 95% CI 1.324-15.152,P=0.016)were independent risk factors for the recurrence of AP in children.SAP group compared with AP group: 15 of 90 AP patients were SAP.Univariate analysis showed that there were significant differences in serum amylase,white blood cell count,ALB and serum calcium between the two groups(P<0.05).Multivariate regression analysis showed that there was a significant difference between SAP group and AP group in white blood cell count(OR=1.253 95% CI 1.092-1.438,P=0.001),and the increase of WBC count could predict the severity of AP in children.Conclusion:1.The etiology of acute pancreatitis in children is mainly pancreatic anatomical abnormalities and biliary origin,and the disease is relatively mild compared with adults,and the prognosis is relatively good.2.The higher the white blood cell count level at admission,the higher the risk of severe acute pancreatitis.3.Acute pancreatitis in children has a high recurrence rate,and early identification of the cause of recurrence can be diagnosed and treated in time to improve the quality of life of patients.