慢性胰腺炎213例的临床特点

Clinical characteristics of 213 patients with chronic pancreatitis

目的:回顾性分析9 a间慢性胰腺炎(CP)的临床特点．方法:对住院诊断CP 213例,按发病情况、临床表现、诊断方法及漏误诊等特点进行统计．结果:CP213例,占消化科住院患者的4．38％, 男女之比1:0．84,9 a间每3 a发病增长为 38．6％,病因:胆源性36．2％,酒精性42．7％,高血脂13．6％,原因不明7．5％;临床表现:持续腹痛仅9．9％,进食后腹痛44％,两者相加为 53．5％,而慢性腹泻或脂肪泻占57％,进高脂肪餐(包括饮酒)后腹胀或腹泻81％,吸收不良 41％,糖尿病7．0％;在诊断方面:72．3％是以临床表现、大便脂肪定性或胰腺外分泌功能试验及CT、EUS影象学特征诊断,27．7％超声内镜引导下细针穿插通过病理诊断,在漏误诊方面:33．8％长期诊断为慢性胃炎或萎缩性胃炎,30．5％诊断为慢性腹泻、肠炎或慢性结肠炎,11．3％诊断为胆系结石或胆囊术后综合症, 3．8％诊断为胰腺新生物或胰腺癌．结论:CP发病率在上升,临床表现腹痛不突出,而且多样性,应早期诊断。

AIM： To conclude the clinical characteristics of 213 chronic pancreatitis （CP） patients during the past 9 years. METHODS： The data of pathogenesis, clinical manifestations, diagnosis and missed diagnosis were retrospectively analyzed in 213 CP patients admitted in the past 9 years. RESULTS： CP patients covered a percentage of 4.38% in department of digestive diseases, and the ratio of male to female was I ： 0.84. The rate of increment every 3 years in the past 9 years was 38.6%. Of 213 cases, the rates were 36.2%, 42.7%, and 13.6% for biliary pancreatitis, alcoholic pancreatitis, and high levels of blood lipid, respectively, and the pathogenesis for 7.5% of 213 was not clear. 9.9% of 213 patients suffered a continual abdominal pain, 44% with abdominal pain after taking food, and 53.5% had the preceding two symptoms. Besides, chronic diarrhea or steatorrhea appeared in 57% patients, abdominal distension or diarrhea in 81% patients after intake of high-fat diet （including alcohol）, malabsorption in 41% patients, and diabetes in 7.0% patients. Of all the patients, 72.3% were diagnosed with clinical manifestations, fatty stool or pancreatitic exocrine function test, computed tomography, and endoscopic ultrasonography, and 27.7% were diagnosed with endoscopic ultrasound guided fine needle aspiration biopsy. Of 213 patients, 33.8% were misdiagnosed with chronic gastritis or atrophic gastritis, 30.5% with chronic diarrhea, enteritis or chronic colitis, 11.3 Yo with biliary stones or postcholecystestomy syndrome, and 3.8% with pancreatic neoplasm or cancer. CONCLUSION： The incidence rate of CP is rising, and its manifestation of abdominal pain is not significant, but of variety. Early diagnosis is important.