Kim Chang Duck
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2003 Jul;42(1):1-11.
The annual incidence of acute pancreatitis (AP) per 100,00 people has increased from 15.6 in 1995 to 19.4 in 2000. Gender distribution revealed male predominance in patients aged between 30 and 60. AP has diverse etiologies. Alcohol consumption and gallstones were the main contribution factors. Due to advanced diagnostic equipments and techniques, the percentage of AP owing to miscellaneous and idiopathic causes has decreased significantly. The mortality rate of AP was 3% in 1980s, 4.4% in the early 1990s, and 2.1% in the late 1990s in Korea. During the late 1990s, the mortality rate has decreased even though the percentage of severe form has increased. This may be partly due to recent advances in medical management. Currently, there is no specific treatment capable of preventing complications of AP. Therefore, it is important to identify patients with severe AP using multiple clinical criteria, CT scans, and laboratory criteria. Close surveillance is necessary for patients with severe AP in order to identify and treat potential complications such as hemorrhage, shock, multiorgan failure as well as infection. Despite our thorough work-up using advanced diagnostic techniques, about one-fifth of the patients remain "idiopathic". As our understanding of AP improves and more advanced endoscopic and imaging techniques become available, this number will continue to decline.
急性胰腺炎(AP)的年发病率(每10万人中)已从1995年的15.6上升至2000年的19.4。性别分布显示,30至60岁的患者中男性居多。AP有多种病因。饮酒和胆结石是主要促成因素。由于先进的诊断设备和技术,由其他及特发性病因导致的AP比例已显著下降。在韩国,AP的死亡率在20世纪80年代为3%,20世纪90年代初为4.4%,20世纪90年代末为2.1%。在20世纪90年代末,尽管重症形式的比例有所上升,但死亡率却有所下降。这可能部分归因于近期医疗管理方面的进展。目前,尚无能够预防AP并发症的特效治疗方法。因此,使用多种临床标准、CT扫描和实验室标准来识别重症AP患者很重要。对重症AP患者进行密切监测,以便识别和治疗潜在并发症,如出血、休克、多器官功能衰竭以及感染。尽管我们使用先进诊断技术进行了全面检查,但仍有约五分之一的患者病因“不明”。随着我们对AP的认识不断提高,以及更多先进的内镜和成像技术问世,这一数字将继续下降。