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急性胰腺炎合并肾综合征出血热:12 例临床分析。

Acute pancreatitis associated with hemorrhagic fever with renal syndrome: clinical analysis of 12 cases.

机构信息

Department of Intensive Care Unit, Ningbo First Hospital , Ningbo , China .

出版信息

Ren Fail. 2013;35(10):1330-3. doi: 10.3109/0886022X.2013.828187. Epub 2013 Aug 21.

DOI:10.3109/0886022X.2013.828187
PMID:23964665
Abstract

BACKGROUND

Acute pancreatitis is one of the rare complications of hemorrhagic fever with renal syndrome (HFRS), which easy to be misdiagnosed as acute abdomen, usually critically ill, poor treatment effect, highly mortality. In this study, we retrospectively analyzed to explore the clinical characteristics, 12 cases of hemorrhagic fever with renal syndrome complicated with acute pancreatitis treatment methods and prognosis.

METHODS

We conducted a retrospective study of HFRS in patients complicated with acute pancreatitis. 12 cases were collected from Ningbo first hospital between January 2001 and December 2012. Clinical information and laboratory parameters were obtained by reviewing literature and records.

RESULTS

Twelve from 156 cases (7.69%) HFRS complicated with acute pancreatitis. Men comprised more than half (75%) of the sample population, the mean age was (38 ± 19) years. Abdominal pain was the main clinical manifestations in all the patients, all of their serum amylase and serum lipase were increased, 10 patients were given the total abdomen CT examination, eight cases showed enlargement of the pancreas and surrounding leakage, two cases showed pancreatic necrosis and hemorrhage. Three cases complicated with pulmonary edema. In 12 cases, four of them received hemodialysis treatment, one gives surgical intervention. Eight cases were complete remission, three cases were partial remission and one case was death.

CONCLUSIONS

Acute pancreatitis is one of rare of the serious complications of HFRS, whereas the correct diagnosis and clear the cause of disease is critical for improve the quality of life of patients and reduce the mortality, timely hemodialysis treatment is effective, early intervention can improve the prognosis.

摘要

背景

急性胰腺炎是肾综合征出血热(HFRS)罕见的并发症之一,易误诊为急腹症,通常病情危重,治疗效果差,死亡率高。本研究回顾性分析探讨 12 例肾综合征出血热并发急性胰腺炎的临床特点、治疗方法及预后。

方法

对我院 2001 年 1 月至 2012 年 12 月收治的 HFRS 并发急性胰腺炎患者进行回顾性研究。共收集 12 例,查阅文献和病历资料,记录临床资料和实验室参数。

结果

156 例 HFRS 患者中并发急性胰腺炎 12 例,占 7.69%。患者中男性占 75%(75%),平均年龄(38±19)岁。所有患者均以腹痛为主要临床表现,血清淀粉酶和血清脂肪酶均升高,10 例行全腹部 CT 检查,8 例胰腺肿大及周围渗出,2 例胰腺坏死出血。3 例并发肺水肿。12 例中,4 例行血液透析治疗,1 例行手术干预。8 例完全缓解,3 例部分缓解,1 例死亡。

结论

急性胰腺炎是 HFRS 少见的严重并发症之一,正确的诊断和明确病因对提高患者的生活质量和降低死亡率至关重要,及时血液透析治疗有效,早期干预可改善预后。

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