广州花都和贵州黔西地区急性胰腺炎发病病因及临床特征的对比研究  

Comparative study on the etiology and clinical characteristics of acute pancreatitis between Huadu of Guangzhou and Qianxi of Guizhou

作　　者：巫泓生 曹天生[1] 廖碧玲 陈亮 马克强 张忠骏 周彦元 WU Hong-sheng;CAO Tian-sheng;LIAO Bi-ling;CHEN Liang;MA Ke-qiang;ZHANG Zhong-jun;ZHOU Yan-yuan(Department of General Surgery,Huadu District People’s Hospital,Guangzhou 510800,China;Department of General Surgery,People’s Hospital of Qianxi,Bijie,Guizhou 551500,China)

机构地区：[1]广州市花都区人民医院普外科,广东广州510800 [2]贵州省黔西县人民医院普外科,贵州毕节551500

出　　处：《肝胆胰外科杂志》2020年第3期143-147,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨广州花都地区和贵州黔西地区急性胰腺炎(AP)的发病病因及临床特征。方法回顾性分析2008年1月至2018年12月广州市花都区人民医院及贵州省黔西县人民医院收治的1 832例AP患者临床资料,对不同地区AP占同期总住院人数的比例、入院时BISAP评分、急性生理功能和慢性健康状况评分II(APACHE-II)、Ranson评分、病因分型、各种并发症及病死率进行统计学对比分析。结果广州花都地区(沿海地区)AP占同期总住院人数的0.21%,贵州黔西地区(山区地区)AP占同期总住院人数的0.47%,沿海地区胆源性胰腺炎占比较山区地区高(57.3% vs 35.8%,P<0.05),而高脂血症性胰腺炎及酒精性胰腺炎山区地区占比较沿海地区高(28.0% vs 19.6%,P<0.05);在基本相同的生长抑素使用率及住院费用情况下,山区地区急性胰腺炎并发器官衰竭及病死率较沿海地区高(7.8% vs 2.6%,P<0.05)。结论山区地区AP发病率较沿海地区高,两地AP病因均以胆源性为主;病因占比方面,沿海地区胆源性AP占比较山区地区高,而酒精性和高脂血症性AP则后者高于前者;山区地区AP病情普遍较沿海地区严重,器官衰竭发生率及病死率较沿海地区高。Objective To investigate the etiology and clinical features of acute pancreatitis(AP)between Huadu region of Guangzhou and Qianxi region of Guizhou.Methods The data of 1832 AP patients from Huadu region of Guangzhou and Qianxi region of Guizhou between Jan.2008 and Dec.2018 were retrospectively analyzed.The proportion of AP patients in the total number of inpatients in the same period between two rgeions,BISAP score at admission,Acute Physiology and Chronic Health Evaluation II(APACHE-II),Ranson score,etiology,complication incidence and mortality between the two regions were statistically analyzed and compared.Results The number of AP patients accounted for 0.21%of the total inpatients in Huadu region(coastal area),while it was 0.47%in Qianxi region(mountainous area)in the same period.The proportion of biliary pancreatitis was higher in coastal area than that in mountainou area(P<0.05),while the proportions of hyperlipidemic pancreatitis and alcoholic pancreatitis were higher in mountainous area than those in coastal area(P<0.05).With basically the same utilization rate of somatostatin and hospitalization expenses,the incidences of organ failure and mortality of AP in mountainous area were higher than those in coastal area(P<0.05).Conclusion The incidence of AP in mountainous area is higher than that in coastal area,and the etiology of AP in both areas is mainly biliary.The proportion of biliary pancreatitis is higher in coastal area than in mountainous area,while the proportions of alcoholic and hyperlipidemic pancreatitis in mountainous area are higher than those in coastal areas.AP in mountainous area is generally more serious than that in coastal area,and the incidences of organ failure and mortality are higher than those in coastal area(P<0.05).

关 键 词：急性胰腺炎 病因学 发病学 临床特征的地区差异 

分 类 号：R657.5[医药卫生—外科学]