Oller B, Armengol M, de Castro J, Iglesias C, Gener J, Inaraja L, Salas M, Salva J A
Rev Esp Enferm Apar Dig. 1989 Dec;76(6 Pt 2):640-4.
We present a retrospective study on 506 patients with acute pancreatitis (AP), admitted in our hospital in the last five years (1984-1988). The goal of the paper is to establish a possible correlation between the severity and the etiology of the AP. Depending on the severity of the acute attack, and according to the Ranson's prognostic signs and the findings of the abdominal CAT, we have classified AP in three grades: mild, moderate and severe. 52% of AP were of biliary etiology, 25.7% alcoholic, and in 17.0% of the cases the responsible agent was not demonstrated. In relation with severity, the distribution was as follows: mild, 184 (36.4%), moderate, 254 (50.2%) and severe, 68 (13.4%). Among the cases of biliary and alcoholic etiology, 14.7% and 9.2%, respectively, were severe. Postoperative AP were severe in 71.4% of the cases. Systemic complications were more frequent in the severe forms, particularly of biliary etiology. Pancreatic abscesses and fistulas were also more frequent in biliary pancreatitis; on the other hand, pseudocysts and ascites were more common in alcoholic pancreatitis. Overall mortality was 2.8% (14 patients). Mortality was 19.1% in the severe forms. In relation to etiology the mortality was as follows: 3.7% in biliary AP; 0.8% in alcoholic AP; 14.3% in postoperative AP; and 2.3% in the idiopathic AP.
我们对过去五年（1984 - 1988年）在我院收治的506例急性胰腺炎（AP）患者进行了一项回顾性研究。本文的目的是确定AP的严重程度与病因之间可能存在的相关性。根据急性发作的严重程度，并依据兰森预后指标和腹部CT检查结果，我们将AP分为三个等级：轻度、中度和重度。52%的AP病因是胆源性的，25.7%是酒精性的，17.0%的病例病因未明确。与严重程度相关的分布情况如下：轻度184例（36.4%），中度254例（50.2%），重度68例（13.4%）。在胆源性和酒精性病因的病例中，分别有14.7%和9.2%为重度。术后AP病例中71.4%为重度。全身并发症在重度类型中更常见，尤其是胆源性病因。胰腺脓肿和瘘在胆源性胰腺炎中也更常见；另一方面，假性囊肿和腹水在酒精性胰腺炎中更常见。总死亡率为2.8%（14例患者）。重度类型的死亡率为19.1%。就病因而言，死亡率如下：胆源性AP为3.7%；酒精性AP为0.8%；术后AP为14.3%；特发性AP为2.3%。
