[摘要] 目的 總結肝移植術後合並急性胰腺炎的診斷及預防治療經驗。方法 對我院2006 ~ 2009年肝移植術後合並急性胰腺炎患者的臨床資料進行回顧性分析。結果 本組肝移植後急性胰腺炎的發生率為5.6%(6/107)，33.3%的急性胰腺炎並發患者移植術中存在胰腺損傷。起病後診斷時間和治療時間分別為(5.1±1.1)d和(21.4±16.3)d；術後血澱粉酶和尿澱粉酶恢複時間分別為(8.0±4.1)d和(16.1±4.4)d；1例術後1個月時發現直徑3cm的胰腺假性囊腫，1例術後2個月並發感染中毒性休克和多器官功能衰竭，除此外無明確並發症，並發症發生率33.3%。目前5例患者健康存活，無胰腺炎複發及慢性胰腺炎出現，治愈率83.3%。1例2個月時死於感染中毒性休克、多髒器功能衰竭，死亡率16.7%。結論 肝移植術中對胰腺的騷擾是並急性胰腺炎的主要因素，診治關鍵在於早期預防、早期診斷及早期正規治療。
[關鍵詞] 肝移植； 急性胰腺炎； 診斷與治療
[中圖分類號] R657.3；R657.5+1 [文獻標識碼] A [文章編號] 1673-9701(2010)03-30-03
Acute Pancreatitis after Liver Transplantation：A Retrospective Analysis
LI Zhu LI Li RAN Jianghua ZHANG Shengning LIU Jing LI Laibang CHEN Juan
The First Department of Hepatobiliary Surgury，the First People’s Hospital ofKunming；the Ganmei Affiliated Hospital of Kunming Medical University，Kunming 650011，China
[Abstract] ObjectiveTo summarize the diagnosis and prevention and treatment of acute pancreatitis after liver transplantation. MethodsWe analyzed clinical data of 6 patients with acute pancreatitis after 107 liver transplantation patients in our hospital from 2006 to 2009. Results The incidence of acute pancreatitis after liver transplantation was 5.6%(6/107)，and the damage of the pancreas was found during the transplantation in 33.3%(2/6)of patients with acute pancreatitis after liver transplantation. The diagnosis time and treatment time after the onset were(5.1±1.1)days and(21.4±16.3)days，respectively. The recovery time of hemodiastase and urinary amylase after surgery was(8.0±4.1)days and(16.1±4.4) days，respectively. One case of pancreatic pseudocyst 3cm in diameter was found one month after surgery，with the complication incidence of 33.3%.One case died of toxic shock and multiple organ failure two month after surgery，with the mortality rate of 16.7%. Five cases still survived and remained healthy，and non-recurrent pancreatitis and chronic pancreatitis occurred，with the cure rate of 83.3%. ConclusionPancreas injure during liver transplant may be the most important factor for acute pancreatitis after liver transplantation. The key to control acute pancreatitis after liver transplantation is to prevent，diagnoze and regularly treat it as early as possible.