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頁籤選單縮合
題名 | Pancreatitis in Children: Clinical Analysis of 61 Cases in Southern Taiwan=兒童胰臟炎--南臺灣61例臨床分析 |
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作者 | 刁茂盟; 莊錦豪; 高常發; 郭馨蔚; 梁啟迪; 陳肇隆; Tiao, Mao-meng; Chuang, Jiin-haur; Ko, Sheung-fat; Kuo, Hsin-wei; Liang, Chi-di; Chen, Chao-long; |
期刊 | 長庚醫學 |
出版日期 | 20020300 |
卷期 | 25:3 2002.03[民91.03] |
頁次 | 頁162-168 |
分類號 | 417.62471 |
語文 | eng |
關鍵詞 | 胰臟炎; 兒童; 腹痛; 天門冬素酵素; Pancreatitis; Children; Abdominal pain; L-asparaginase; |
中文摘要 | 背景: 本研究的目的,是分析本院在南臺灣,兒童胰臟炎的臨床症狀、原因、診斷及治療情形。 方法: 經由本院1986年7月到2000年6月間病歷資料統計,收集了61例兒童胰臟炎,年齡由2歲到18歲(平均8.8±4.8歲)。 結果: 二十八例是由於身體的撞傷所造成,其中車禍有13例(53.8%是由於機車車禍所造成)。其他造成原因包括,本身疾病所引起的有9例,胰臟膽道異常的有7例,毒素或藥物引起的有4例,蛔蟲感染引起的有1例、不明原因有12例。58例有腹痛情形,23例有嘔吐,18例有發燒,2例有黃膽。51例有高血清澱粉脢(83.6%)。在30例檢驗血脂肪脢當中,有27例(90.0%)大於190 U/L;在35例檢驗澱粉脢對肌氨酸清除比值當中,有28例(80.0%)大於6%。51例接受超音波掃描,其中40例顯示有胰臟發炎;21例接受電腦斷層掃描,均有胰臟發炎的現象。46例採用保守治療,而15例須開刀治療。復發的病例有9例;另外1例白血病病人在施打天門冬素酵素(L-asparaginase)三天後,因為急性壞死性胰臟炎而死亡,其他病人在長期追蹤中均存活。 結論: 兒童胰臟炎比一般相信的還常見。身體的撞傷,尤其是機車車禍,在南臺灣是造成兒童胰臟炎最常見的原因。除了1例因使用天門冬素酵素進行化學治療引起胰臟炎而死亡之外,一般而言死亡率很低。 |
英文摘要 | Background: The purpose of this study was to analyze the characteristics of the clinical presentations, etiologies, diagnoses, and treatment of pediatric pancreatitis in southern Taiwan. Methods: Sixty-one patients, ranging in age from 2 to 18 years (mean, 8.8±4.8 years old), with diagnoses of pancreatitis were studied from July 1986 through June 2000. Results: Twenty-eight pancreatitis cases resulted from physical trauma, 13 cases of which were from traffic accident (53.8% from motorcycle accident). Other pathogenic factors included systemic diseases (N=9), pancreaticobiliary-tree anomalies (N=7), toxin ingestion or drug use (N=4). Ascaris infection (N=1), and idiopathic (N=12). Symptoms included abdominal pain (N=58), vomiting (N=23), fever (N=18), and jaundice (N=2) Hyperamylaemia was found in 51 children (83.6%). Twenty-seven patients (90.0%) had elevated serum lipase levels (>190 U/L) of 30 evaluated. The amylase to creatinine clearance ratio was assayed for 35 cases, of which 28 (80.0%) were elevated (>6%). Ultrasonography revealed inflammatory changes of the pancreas in 40 of 51 patients evaluated. which computed tomogram demonstrated evidence of pancreatic inflammation for all 21 patients evaluated. Fifteen cases required surgery, which the other 46 were managed conservatively. One patient died because of acute necrotizing pancreatitis 3 days after L-asparaginase treatment for leukemia. The other patients survived well during long-term follow up. Conclusion: Pancreatitis in children is more common than generally believed. Physical trauma, especially because of motorcycle accidents, was the leading cause of pediatric pancreatitis in southern Taiwan. The mortality rate was low. Only one patient who had undergone chemotherapy with L-asparaginase died of the disease. |
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