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急性-on-慢性胰腺炎:临床特征与结局分析

Acute-on-Chronic Pancreatitis: Analysis of Clinical Profile and Outcome.

作者信息

Sharma Dibyajyoti, Mallick Bipadabhanjan, Samanta Jayanta, Gupta Vikas, Sinha Saroj K, Kochhar Rakesh

机构信息

Internal Medicine, Gastroenterology, Silchar Medical College and Hospital, Silchar, IND.

Gastroenterology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

出版信息

Cureus. 2021 Apr 1;13(4):e14242. doi: 10.7759/cureus.14242.

Abstract

OBJECTIVE

Overall, a handful of studies are available on the outcomes of acute-on-chronic pancreatitis (ACP). We aimed to provide a more complete and updated picture of ACP.

METHODS

We evaluated consecutive patients of acute exacerbation of chronic pancreatitis (CP) in a tertiary care center located in north India and studied their epidemiological profiles, etiological factors as well as outcomes.

RESULTS

Forty-five patients of ACP with a mean age of 37±13 years were evaluated. The majority of the patients were male (75%) and alcohol was the most common detectable etiology while no etiology could be identified in 35% of patients after extensive laboratory investigations and imaging. Moderately severe pancreatitis was noted in 73% of patients and 49% of patients had necrotizing pancreatitis out of which the majority (33%) had both pancreatic as well as extra-pancreatic necrosis (EPN). Five patients (11%) were subjected to percutaneous catheter drainage. Persistent organ failure was noted in 9% of patients and two (4.5%) patients had died from organ failure.

CONCLUSION

To conclude, this study has demonstrated that ACP has a milder disease course and low morbidity and mortality. Early elimination of the etiological factor is essential for optimal outcome.

摘要

目的

总体而言,关于急性慢性胰腺炎(ACP)的研究较少。我们旨在提供更完整和最新的ACP情况。

方法

我们评估了位于印度北部一家三级医疗中心的慢性胰腺炎(CP)急性加重的连续患者,并研究了他们的流行病学特征、病因以及预后。

结果

评估了45例平均年龄为37±13岁的ACP患者。大多数患者为男性(75%),酒精是最常见的可检测病因,而在进行广泛的实验室检查和影像学检查后,35%的患者无法确定病因。73%的患者为中度重症胰腺炎,49%的患者为坏死性胰腺炎,其中大多数(33%)既有胰腺坏死又有胰腺外坏死(EPN)。5例患者(11%)接受了经皮导管引流。9%的患者出现持续性器官衰竭,2例(4.5%)患者死于器官衰竭。

结论

总之,本研究表明ACP病程较轻,发病率和死亡率较低。尽早消除病因对于获得最佳预后至关重要。

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Fibrosis reduces severity of acute-on-chronic pancreatitis in humans.纤维化减轻人类急性加重慢性胰腺炎的严重程度。
Gastroenterology. 2013 Aug;145(2):466-75. doi: 10.1053/j.gastro.2013.05.012. Epub 2013 May 15.

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