摘要
目的总结慢性胰腺炎(CP)的诊治经验。方法回顾性总结分析97例CP病人的临床资料和诊治体会。结果病因方面,为嗜酒5年以上、胆系结石和急性胰腺炎病史分别占46.6%,35.0%和17.5%。临床表现上,长期慢性腹痛、体重减轻3㎏以上、糖尿病分别为98%,40%,17.5%。影像学检查的阳性率B超90%,CT、ERCP、MRCP均为100%。临床和影像根据发现为胰头肿块、钙化结石、假性囊肿或仅有胰腺外型和胰管明显改变,分为四川临床类型,分别占27.8%、29.8%、28.9%和13.4%,全组非手术治疗42例,症状减轻者38例(90%);手术治疗55例,效果良好者43例(78%),疼痛明显减轻者10例(18%)。结论CP的诊断主要依靠现代影像学检查。症状较轻、无明显胰、胆管梗阻者可行非手术治疗。外科治疗应根据病变发现和临床类型,选择不同的手术方式。
Objective To discuss the experience of diagnosis and treatment of chronic pancreatitis. Methods The clinical materials of 97 cases of chronic pancreatitis were retrospectively analyzed. Results Etiologically, there were heavy drinking for over 5 years in 46.6%, biliary calculi in 35% and history of acute pancreatitis in 17.5% of the patients. Symptomatically, chronic abdominal pain were present in 98%, body weight loss over 3 kg in 40% and diabetes in 17.5% of the cases. The positive rate in different imaging examinations was: B-ultrasound 90%; CT, ERCP and/or MRCP 100%. According to the presence of tumefaction of the pancreas head (27.8%), intraductal calculi of the pancreas (29.8%), pseudo-cyst (28.9%) and distorted shape of the pancreas or the pancreatic ducts (13.4%), chronic pancreatits was classified into four clinical types. Forty-two cases were treated medically, of which 38 were reduced in pain (90%). Fifty-five cases underwent operation, 43 cases(78%) were cured , and 10 cases (18%) were reduced in pain. Conclusions The diagnosis of pancreatitis depends mostly on modern imaging techniques. Cases withnot evidence of obstruction of the pancreatic or biliary ducts could be treated medically.Appropriate operative procedure should be chosen as required.
出处
《外科理论与实践》
2004年第4期301-303,共3页
Journal of Surgery Concepts & Practice
关键词
慢性胰腺炎
诊断
治疗
Chronic pancreatitis
Diagnosis
Treatment
