儿童急性胰腺炎复发危险因素的临床分析  

Clinical analysis of risk factors for recurrence of acute pancreatitis in children

作　　者：谭春秀 杨颖 王鵷臻 黄李雅 TAN Chunxiu;YANG Ying;WANG Yuanzhen;HUANG Liya(School of Clinical Medicine,Ningxia Medical University,Department of Gastroenterology,General Hospital of Ningxia Medical University,Yinchuan 750004,Ningxia,China)

机构地区：[1]宁夏医科大学临床医学院、宁夏医科大学总医院消化内科,宁夏银川750004

出　　处：《临床儿科杂志》2023年第7期526-529,548,共5页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童急性胰腺炎复发的危险因素。方法回顾性分析2010年12月至2020年12月医院收治的明确诊断为急性胰腺炎(AP)患儿的临床资料。将患儿分为AP组和急性胰腺炎复发(RAP)组,比较两组临床特征,并分析儿童AP复发的影响因素。结果纳入90例AP患儿,男55例、女35例,中位年龄为9.0(6.0~12.0)岁。RAP组24例,发生于第一次AP发病后的6.6(1.0~11.6)月,中位年龄10.0(7.0~12.0)岁。复发因素多为特发性AP(9例,37.5%),胰腺解剖学异常(7例,29.2%)和胆源性(5例,20.8%)。90例AP患儿中,重度AP 15例,其中RAP组8例,AP组7例。90例AP患儿中,腹痛、呕吐发生率分别为83.3%和32.2%;胰腺坏死和胰腺假性囊肿的发生率分别为5.6%、6.7%。多因素logistic回归分析结果显示,胰腺解剖学异常和重度AP是儿童AP患者复发的独立危险因素(P<0.05),特发性AP是儿童AP患者复发的独立保护因素(P<0.05)。结论重度AP,有胰腺解剖学异常的AP患儿容易复发,需引起临床医师的重视。Objective To investigate the risk factors for the recurrence of acute pancreatitis in children.Methods The clinical data of children with acute pancreatitis(AP)admitted to the General Hospital of Ningxia Medical University from December 2010 to December 2020 were analyzed retrospectively.The children were divided into AP group and recurrent acute pancreatitis(RAP)group.The clinical characteristics of the two groups were compared,and the influencing factors of AP recurrence in children were analyzed.Results A total of 90 AP children(55 boys and 35 girls)were included,and the median age was 9.0(6.0-12.0)years.In the RAP group,24 patients recurred 6.6(1.0-11.6)months after the first onset of AP,with a median age of 10.0(7.0-12.0)years.The common causes of recurrence were idiopathic AP(9 cases,37.5%),pancreatic anatomical abnormalities(7 cases,29.2%)and biliary origin(5 cases,20.8%).Among the 90 children with AP,15 had severe AP,including 8 in RAP group and 7 in AP group.Among 90 AP children,the incidence of abdominal pain and vomiting were 83.3%and 32.2%.The incidence of pancreatic necrosis and pancreatic pseudocyst was 5.6%and 6.7%.Multivariate logistic regression analysis showed that abnormal pancreatic anatomy and severe AP were independent risk factors for recurrence of AP in children(P<0.05),and idiopathic AP was an independent protective factor for recurrence of AP in children(P<0.05).Conclusions Patients with severe AP and abnormal pancreatic anatomy are prone to recurrence,which should be paid attention to by clinicians.

关 键 词：急性胰腺炎 复发 儿童 

分 类 号：R725.7[医药卫生—儿科]