Citation: | SUN Haili, SHEN Aiwu, CHEN Ken. The causes of acute recurrent pancreatitis and endoscopic therapy[J]. Journal of Clinical Medicine in Practice, 2022, 26(20): 81-84. DOI: 10.7619/jcmp.20221627 |
To analyze the causes of patients with acute recurrent pancreatitis (RAP), efficacy of endoscopic therapy and prognosis.
The clinical data of 127 patients with RAP admitted from October 2018 to October 2020 were retrospectively analyzed. According to different treatment methods, the patients were divided into endoscopic group (endoscopic treatment, n=46), drug group (drug treatment, n=33) and surgery group (surgical treatment, n=48). The causes of the three groups were analyzed. The average recurrence times before admission, the time from the first attack to admission, and the recurrence rate within 3 years before operation were compared among the three groups. The prognosis, recurrence and death of the three groups were analyzed.
Biliary calculus was the most common cause of RAP, accounting for 30.71% (39/127), followed by hyperlipidemia, accounting for 24.41% (31/127). There were no significant differences in etiology, average recurrence times before admission, time from the first attack to admission, recurrence rate within 3 years before operation, cure rate, improvement rate and ineffective rate among the three groups (P>0.05). All patients in the endoscopic group were cured or improved after treatment, without aggravation. The physical, role, emotion, cognition and social function scores in the endoscopic group were significantly higher than those in the drug group and surgery group (P < 0.05). During follow-up, the recurrence rate of the endoscopy group was significantly lower than that of the drug group and surgery group (P < 0.05).
The main pathogenic factors of RAP are biliary factor, hyperlipidemia and alcohol. Endoscopic treatment can effectively reduce the recurrence rate and improve the prognosis of RAP patients.
[1] |
董玉, 闫凯, 程海玲. TREM-1、H2S联合ACE2检测对重症急性胰腺炎预后的评估价值[J]. 分子诊断与治疗杂志, 2021, 13(2): 284-287. doi: 10.3969/j.issn.1674-6929.2021.02.029
|
[2] |
刘畅, 宋建梅, 李晓阳. NLR、PLR在高脂血症性急性胰腺炎诊断及病情评估中的价值[J]. 分子诊断与治疗杂志, 2021, 13(3): 380-383, 387. doi: 10.3969/j.issn.1674-6929.2021.03.012
|
[3] |
余婷媛, 税金凤, 李亚男. 奥美拉唑联合免疫肠内营养治疗重症急性胰腺炎的临床疗效及对T淋巴细胞亚群和细胞因子的影响[J]. 解放军医药杂志, 2018, 30(3): 73-76. doi: 10.3969/j.issn.2095-140X.2018.03.019
|
[4] |
伍小鱼, 潘勇. 生长抑素联合硫酸镁治疗重症急性胰腺炎的效果评价[J]. 解放军医药杂志, 2018, 30(8): 74-77. doi: 10.3969/j.issn.2095-140X.2018.08.019
|
[5] |
杨胜利, 陈元姝, 梁崇国, 等. 连续性血液净化联合生长抑素治疗重症急性胰腺炎效果及对患者炎性因子、T淋巴细胞亚群影响[J]. 临床误诊误治, 2018, 31(11): 34-38. doi: 10.3969/j.issn.1002-3429.2018.11.009
|
[6] |
刘婷, 赵胜兵, 苏晓菊, 等. 临床表现不典型的自身免疫性胰腺炎一例诊断过程分析[J]. 临床误诊误治, 2018, 31(1): 20-21. doi: 10.3969/j.issn.1002-3429.2018.01.007
|
[7] |
赵登秋, 陈益鸣, 邬叶锋, 等. 早期内镜治疗老年急性胆源性胰腺炎对炎症因子及临床疗效的影响[J]. 中华内分泌外科杂志, 2021(5): 514-517. doi: 10.3760/cma.j.cn.115807-20210218-00050
|
[8] |
朱珠, 张娜, 王静雯. 复发性急性胰腺炎的相关影响因素及其护理干预对策[J]. 医学临床研究, 2018, 35(10): 2076-2078. doi: 10.3969/j.issn.1671-7171.2018.10.076
|
[9] |
田泽敏, 高青. 复发性急性胰腺炎相关危险因素及治疗分析[J]. 胃肠病学和肝病学杂志, 2018, 27(1): 22-24. doi: 10.3969/j.issn.1006-5709.2018.01.004
|
[10] |
YASUDA H, HORIBE M, SANUI M, et al. Etiology and mortality in severe acute pancreatitis: a multicenter study in Japan[J]. Pancreatology, 2020, 20(3): 307-317. doi: 10.1016/j.pan.2020.03.001
|
[11] |
DRONOV O, KOVALSKA I, SHCHYHEL I, et al. Etiology of acute pancreatitis: Hypertriglyceride-associated acute pancreatitis and alcohol abuse[J]. Pancreatology, 2021, 21: S42.
|
[12] |
何湛, 张家敏. 乌司他丁联合加贝酯冲击治疗对急性胰腺炎患者炎症水平预后和复发的影响[J]. 中国药物与临床, 2019, 19(22): 3841-3844. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201922003.htm
|
[13] |
JEAN-MARIE E M, CHO J J, TREVINO J G. A case report of recurrent acute pancreatitis associated with life threatening atypical hemolytic uremic syndrome[J]. Medicine, 2020, 99(22): e19731. doi: 10.1097/MD.0000000000019731
|
[14] |
张国平, 刘勇, 敬敏. 内镜治疗急性胆源性胰腺炎的临床疗效[J]. 中国内镜杂志, 2018, 24(10): 78-81. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201810016.htm
|
[15] |
BURATTINI O, LOSURDO G, MARANGI S, et al. An uncommon etiology of pancreatitis after endoscopic ultrasound-guided fine needle aspiration[J]. Endoscopy, 2020, 52(3): E106-E107. doi: 10.1055/a-1011-3796
|
[16] |
MASAMUNE A, KIKUTA K, HAMADA S, et al. Clinical practice of acute pancreatitis in Japan: an analysis of nationwide epidemiological survey in 2016[J]. Pancreatology, 2020, 20(4): 629-636. doi: 10.1016/j.pan.2020.04.013
|
[17] |
李文婷, 党彤. 复发性急性胰腺炎病因的研究进展[J]. 胃肠病学, 2018, 23(6): 378-381. doi: 10.3969/j.issn.1008-7125.2018.06.013
|
[18] |
JOURY A, ALSHEHRI M, MAHENDRA A, et al. Therapeutic approaches in hypertriglyceridemia-induced acute pancreatitis: a literature review of available therapies and case series[J]. J Clin Apher, 2020, 35(2): 131-137. doi: 10.1002/jca.21763
|
[19] |
沈凤, 王保健, 顾文芬. ERCP治疗急性胆源性胰腺炎疗效及其术后并发症的影响因素分析[J]. 陕西医学杂志, 2018, 47(8): 984-986, 993. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYZ201808010.htm
|
[20] |
GUDA N M, MUDDANA V, WHITCOMB D C, et al. Recurrent acute pancreatitis: international state-of-the-science conference with recommendations[J]. Pancreas, 2018, 47(6): 653-666.
|
1. |
张向前,兰堃田,李伟明. 外周血循环肿瘤细胞动态变化与晚期食管癌化疗患者预后的关系. 医药论坛杂志. 2024(21): 2261-2265 .
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