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捷布尼察地区急性胰腺炎的流行病学特征

Epidemiological characteristic of acute pancreatitis in Trzebnica district.

作者信息

Bogdan Justyna, Elsaftawy Ahmed, Kaczmarzyk Janusz, Jabłecki Jerzy

机构信息

Department of General Surgery, Hospital St Hedwig of Silesia in Trzebnica.

出版信息

Pol Przegl Chir. 2012 Feb;84(2):70-5. doi: 10.2478/v10035-012-0011-6.

Abstract

Acute pancreatitis is one of the most common surgical disease, and thus cause of hospitalization. Incidence and etiology of this condition demonstrates large regional differences. This situation is a substantial financial burden forhospital district, and changes in organization structure and funding medical service should be taken under consideration.The aim of the study was to record the epidemiology with etiology, diagnosis and treatment of acute pancreatitis in large district (77 000 inhabitants).Material and methods. A meta-analysis study of all 298 patients admitted to Hospital St Hedwig in Trzebnica, in the six-year period from 2005 to 2010, with acute pancreatitis was performed.Results. Acute pancreatitis was diagnosed in 298 patients in the six - year period, giving an estimated incidence of 64.4 per 100 000. Among the group of 441 admissions for acute pancreatitis in 298 patients was confirmed. Severe acute pancreatitis developed in 22.5% (67/298) of patients, more often in males 56/208 (27%) than in females 11/90 (12%). Gallstones were found as an etiological factor in 27% (80/298), and alcohol intake in 49% of patients. 211/298 (70%) patients had only one attack, whereas 29% (87/298) were readmitted with 230 relapses. The risk of recurrent pancreatitis was 48% in alcohol induced and 6,25% in gallstone induced pancreatitis. 53/298 patients (17%) were operated, ERCP procedures were performed in 24.Performed operations: necrosectomy in 25/53 (47%), elective cholecystectomy in 16/53 (30%), open drainage of abdominal abscess in 5/53 (9%), open drainage of cysts in 5/53 (9%), Jurasz's operation in 2/53 (3%). Majority surgical treatment was carried out in 68% cases with severe acute pancreatitis. Mortality due to acute pancreatitis was 3% (10/298); 15% in severe pancreatitis.Conclusions. 1. Acute pancreatitis continues to be an important clinical problem. 2. Severe, necrotic acute pancreatitis is associated with high mortality rates. 3. The ethanol-intake-related episodes of acute pancreatitits are much more prevalent than the gall-stone-related ones. 4. After the exclusion of ethanol- and gall-stones-related etiologies, the subsequent diagnostic process should aim at excluding neoplastic process of the head of pancreas.

摘要

急性胰腺炎是最常见的外科疾病之一,也是住院的常见原因。这种疾病的发病率和病因在不同地区存在很大差异。这种情况给医院带来了巨大的经济负担,因此应考虑组织结构和医疗服务资金的变化。本研究的目的是记录一个大区域(77000名居民)内急性胰腺炎的流行病学情况,包括病因、诊断和治疗。

材料与方法。对2005年至2010年期间在特热布尼采的圣海德薇格医院收治的298例急性胰腺炎患者进行了荟萃分析研究。

结果。在六年期间,298例患者被诊断为急性胰腺炎,估计发病率为每10万人64.4例。在298例患者的441次急性胰腺炎入院病例中得到证实。22.5%(67/298)的患者发展为重症急性胰腺炎,男性56/208(27%)比女性11/90(12%)更常见。27%(80/298)的患者病因是胆结石,49%的患者病因是饮酒。211/298(70%)的患者仅发作一次,而29%(87/298)的患者再次入院,复发230次。酒精性胰腺炎复发风险为48%,胆结石性胰腺炎复发风险为6.25%。53/298例患者(17%)接受了手术,24例患者进行了内镜逆行胰胆管造影(ERCP)操作。实施的手术:25/53(47%)为坏死组织清除术,16/53(30%)为择期胆囊切除术,5/53(9%)为腹腔脓肿开放引流术,5/53(9%)为囊肿开放引流术,2/53(3%)为尤拉斯手术。大多数手术治疗是在68%的重症急性胰腺炎病例中进行的。急性胰腺炎的死亡率为3%(10/298);重症胰腺炎的死亡率为15%。

结论。1. 急性胰腺炎仍然是一个重要的临床问题。2. 重症坏死性急性胰腺炎与高死亡率相关。3. 酒精摄入相关的急性胰腺炎发作比胆结石相关的更为普遍。4. 在排除酒精和胆结石相关病因后,后续诊断过程应旨在排除胰腺头部的肿瘤性病变。

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