单中心儿童胰腺炎临床特征分析  

Clinical features of pancreatitis in children:a single center retrospective study

作　　者：王姣 钟雪梅[1] 张艳玲[1] 朱丹[1] 马昕[1] 宁慧娟[1] 宫幼喆[1] Wang Jiao;Zhong Xuemei;Zhang Yanling;Zhu Dan;Ma Xin;Ning Huijuan;Gong Youzhe(Department of Gastroenterology,Children′s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院消化内科,北京100020

出　　处：《中国小儿急救医学》2022年第8期631-634,共4页Chinese Pediatric Emergency Medicine

基　　金：北京市医院管理局消化内科学科协同发展中心消化专项重点项目(XXZ0505)。

摘　　要：目的:探讨儿童胰腺炎的临床特征,分析儿童急性胰腺炎(AP)、急性复发性胰腺炎(RAP)以及慢性胰腺炎(CP)间临床差异。方法:回顾2015年1月至2020年12月在首都儿科研究所附属儿童医院消化内科住院治疗的儿童AP、RAP以及CP病例,统计各病临床特征并进行分析。结果:纳入病例109例,其中AP 69例(63.3%),RAP 22例(20.2%),CP 18例(16.5%)。各年龄段患儿构成比差异有统计学意义( P<0.001),学龄期及青春期患儿占比较高,分别为48.6%和29.4%。特发性为AP、RAP及CP的主要病因,其余病因包括胆源性、病毒感染、结构异常、药物性、高胆固醇血症及遗传性。97.2%(106例)患儿伴有腹痛发作,以中上腹(75例,70.8%)及脐周(22例,20.8 %)为主。学龄前AP患儿胰腺增大以弥散性增大为主(11/12),而学龄后AP患儿局部增大和弥散增大占比相同,差异有统计学意义( P=0.037)。CP患儿的身高评分低于人群总体均值(0分),且低于AP、RAP患儿,差异有统计学意义[-0.65(-1.57,0.25),0.36(-1.03,1.05),-0.09(-0.30,0.41), H=6.021, P=0.044]。8例(11.6%)AP患儿进展为RAP,6例AP(8.7%)进展为CP。 结论:胰腺炎好发于学龄期及青春期儿童,特发性是各种类型胰腺炎的首发病因。AP、RAP及CP在病因构成及临床表现方面具有胰腺炎共同的疾病特点。相较AP及RAP,CP更易影响患儿生长发育。部分AP可进展为RAP或CP,应注意加强AP患儿的病因排查,及时祛除病因以避免疾病进展。Objective To explore the clinical characteristics of children with pancreatitis,aiming to analyze the clinical differences of acute pancreatitis(AP),recurrent acute pancreatitis(RAP)and chronic pancreatitis(CP)in children.Methods The clinical characteristics of AP,RAP,CP in children admitted to the Department of Gastroenterology at Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2015 to December 2020 were analyzed.Results One hundred and nine cases were included in this study,including 69 cases of AP(63.3%),22 cases of RAP(20.2%)and 18 cases of CP(16.5%).The proportion of school-age and adolescent children was 48.6%and 29.4%,and there was statistical difference between the composition of children at different ages(P<0.001).Idiopathic was the main cause of AP,RAP and CP.The other causes included biliary,viral infection,structural abnormalities,drug-induced,hypercholesterolemia and heredity.97.2%(106 cases)of the children were accompanied by abdominal pain,mainly in middle and upper abdomen(75 cases,70.8%)and around umbilical cord(22 cases,20.8%).The pancreatic enlargement in preschool children was mainly diffuse enlargement(11/12),while the older children with local enlargement and diffuse enlargement accounted for the same proportion,the difference was statistically significant(P=0.037).The height score of CP children was lower than the overall average of the population(0 score),and lower than those of AP and RAP children,with statistically significant difference[-0.65(-1.57,0.25)vs.0.36(-1.03,1.05)and-0.09(-0.30,0.41),H=6.021,P=0.044].Eight(11.6%)cases with AP progressed to RAP,and six(8.7%)cases with AP progressed to CP.Conclusion Pancreatitis tends to occur in school-age and adolescent children,and idiopathic is the first cause of all types of pancreatitis.AP,RAP,and CP share common features of pancreatitis in terms of etiology composition and clinical manifestations.Compared with AP and RAP,CP is more likely to affect the growth and development of children.Some children with A

关 键 词：儿童 急性胰腺炎 慢性胰腺炎 急性复发性胰腺炎 

分 类 号：R725.7[医药卫生—儿科]