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目的:回顾性分析我院急性胰腺炎(AP),特别是重症急性胰腺炎(SAP)和高脂血症性急性胰腺炎(HLAP)的概况。方法:选取我院2010-01-2016-12期间共1 345例AP患者的住院资料,重点分析2012-01-2016-03急诊科病房(留观及监护室)收治入院的341例AP患者的临床资料,包括人口学特征、疾病严重程度等级、病因及实验室资料等。结果:1 345例AP患者平均发病年龄为(54.16±16.83)岁,男女比例为1.46∶1,病死率为1.56%。期间,急诊科的AP诊治比例自2010年的16%上升至2015年59%。其中2012-01-2016-03急诊科收治的341例AP住院患者,共有SAP 22例(死亡5例)、轻度急性胰腺炎(MAP)155例、中度急性胰腺炎(MSAP)164例。平均住院天数上,MAP组要少于MSAP组(P<0.05)。其在病因分布上,依次为胆源性急性胰腺炎(BAP)74例,酒精性急性胰腺炎(AAP)36例、HLAP14例。在HLAP组中,SAP所占比例明显高于其在BAP组以及AAP组(P<0.05)。其中,118例AP伴有高甘油三酯血症(HTG),其复发率远高于223例不伴HTG的AP(P<0.05)。结论:AP在急诊科的诊治比例呈逐年上升趋势。急诊科已成为承担AP诊治工作的主要科室。另外,高脂血症性AP有年轻化趋势,好发于男性,病情更重。而伴随HTG的AP患者更易复发。
Objective: To retrospectively analyze the status of acute pancreatitis (AP) in our hospital, especially severe acute pancreatitis (SAP) and hyperlipidemic acute pancreatitis (HLAP). Methods: A total of 1 345 cases of hospitalized patients with AP in our hospital from January 2010 to December 2016 were selected. The focus of the analysis was to analyze 341 cases of AP patients admitted to hospital Clinical data, including demographic characteristics, disease severity, etiology and laboratory data. Results: The average age of onset of AP in 1 345 cases was (54.16 ± 16.83) years old, the ratio of male to female was 1.46:1, and the case fatality rate was 1.56%. During the period, the proportion of emergency department AP diagnosis and treatment increased from 16% in 2010 to 59% in 2015. Of the 341 AP inpatients admitted to the emergency department from January 2012 to June 2016, there were 22 SAP patients (5 deaths), 155 mild pancreatitis (MAP) and 164 moderate acute pancreatitis (MSAP). On the average length of hospital stay, MAP group was less than that of MSAP group (P <0.05). The distribution of etiology, followed by 74 cases of biliary acute pancreatitis (BAP), alcoholic acute pancreatitis (AAP) in 36 cases, HLAP14 cases. In the HLAP group, the proportion of SAP was significantly higher than that in the BAP group and the AAP group (P <0.05). Among them, 118 cases of AP with hypertriglyceridemia (HTG), the recurrence rate was much higher than 223 cases without HTG AP (P <0.05). Conclusion: The rate of diagnosis and treatment of AP in the emergency department shows an upward trend year by year. Emergency department has become the main department responsible for AP diagnosis and treatment. In addition, hyperlipidemic AP younger trend occurs in men, more serious condition. AP patients with HTG are more likely to relapse.