尼泊尔三级卫生保健中心急性胰腺炎的临床概况和结果

Ajay Kumar Gautam, Khus Raj Dewan, Rishab Shrestha, Vijaya K.C.
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摘要

急性胰腺炎是胰腺实质的炎症,可引起局部和全身表现。本研究旨在了解某三级医疗中心消化科患者急性胰腺炎的临床特征和预后。方法一项基于医院的横断面研究,包括75例急性胰腺炎患者,于2022年8月至2023年6月入选。研究了临床概况、并发症和结果,包括住院死亡率。采用修订的亚特兰大分级法和修订的CT严重程度指数进行诊断和分级。数据录入和分析采用SPSS-17进行。结果40 ~ 60岁为最常见年龄组(50.7%);最常见的病因是酒精(46.7%),几乎所有的患者都表现为腹痛(97%),80%的患者有腹部压痛。以轻度胰腺炎为主(54.7%),其次为中重度(32%)和重度胰腺炎(13.3%)。与住院时间延长及死亡率显著相关的因素有:胸腔积液、坏死性胰腺炎、急性肾损伤、BISAP评分≥2分、白细胞总数高、休克、严重CT严重程度评分、多器官功能障碍综合征(MODS)、急性呼吸窘迫综合征(ARDS)(p≤0.05)。结论急性胰腺炎以男性和40 ~ 60岁年龄组为主。它与严重的并发症和死亡率有关。BISAP评分高、胸膜积液、急性肾损伤、白细胞增多、就诊时CRP水平高是预测预后的有效指标。
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Clinical Profile and Outcome of Acute Pancreatitis in a Tertiary Health Care Center of Nepal
IntroductionAcute pancreatitis is the inflammation of pancreatic parenchyma that can cause local and systemic manifestations. This study aimed to find the clinical profile and an outcome of acute pancreatitis among patients attending the Department of Gastroenterology in a tertiary care center.MethodsA cross-sectional hospital based study comprising of 75 patients of acute pancreatitis, enrolled between August 2022 to June 2023. Clinical profile, complications and outcomes including in hospital mortality were studied. Revised Atlanta classification and modified CT severity index were used for diagnosis and classification. Data entry and analysis were done SPSS-17.ResultsMost common age group was 40-60 years (50.7%). The most common etiology was alcohol (46.7%) and almost all presented with abdominal pain (97%) and abdominal tenderness was present in 80%. Majority were mild pancreatitis (54.7%), followed by moderately severe (32%) and severe pancreatitis (13.3%). Factors that are significantly associated with prolonged stay at hospital and mortality were pleural effusion, necrotizing pancreatitis, acute kidney injury, BISAP score ≥ 2, high total leucocyte count, shock, severe CT severity score, multi organ dysfunction syndrome (MODS), acute respiratory distress syndrome (ARDS)(p≤0.05).ConclusionsAcute pancreatitis is predominant in male gender and 40-60 years age group. It is associated with significant complications and mortality. Different parameters including high BISAP score, pleural effusions, acute kidney injury, leucocytosis and high CRP level on presentation were useful markers to predict outcome.
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