慢性胰腺炎131例临床病例分析

Clinical analysis of 131 patients with chronic pancreatitis.

目的通过回顾性分析慢性胰腺炎（CP）的临床特点．各种检查方法的准确性，以提高对CP的诊治水平。方法以1987年桂林慢性胰腺炎会议提出的CP诊断标准评定所收集的1992年2月～2004年8月间住院治疗的CP患者的临床资料。应用Logestic回归分析临床症状和体征对诊断的提示意义．用x^2检验比较各种影像学检查的敏感性。结果一共收集到165例患者，其中符合诊断标准的有131例．男性97例．女性34例（男女比例为2．85：1）．平均年龄49．4岁。腹痛为主要症状，与CP诊断相关。BT—PABA实验及其纠正实验敏感性为94．4%。腹平片检查敏感性为62．5%，B超69．1%．CT88．3％．MR83．9％，ERCP 86．1％。CT、MR、ERCP优于腹平片和B超（P=0．010，0．033）。但三者之间的差别没有统计学意义。结论CP的临床症状主要以腹痛为主．不具有特异性，诊断应该结合临床、实验室检查、影像学检查、病理学综合考虑。

Objective To investigate the clinical profiles of chronic pancreatitis （CP） and the accuracy of different examination methods, so as to improve the diagnosis and treatment of chronic pancreatitis. Methods Data of CP patients who were referred to our hospital from Feb. 1992 to Aug. 2004 were collected. CP patients were diagnosed according to the standard established in Guilin in 1987. Logistic regression analysis was used to evaluate the role of clinic symptoms and signs in diagnosis of chronic pancreatitis. x^2 was used and a P value less than 0. 05 was regard as significant. Results Totally 131 patients （male 97. female 34, M/F 2.85 ： 1） were included in the present study. The average age was 49.4 years old. The main manifestation was abdominal pain, which was associated with CP diagnosis. The sensitivities of BT-PABA test, abdominal X- ray. B ultrasound, computed tomography （CT）. magnetic resonance （MR）. and endoscopic retrograde cholangiopancreatography （ERCP） were 94. 4%. 62. 5%. 69. 1%, 88.3%. 83. 9%. and 86.4%. respectively. CT, MR, and ERCP were superior to abdominal X ray and Bultrasound（P =0.010, 0. 035）in diagnosis of CP. There was no significant difference between CT. MR, and ERCP. Conclusions The main manifestation of chronic pancreatitis is abdominal pain. but abdominal pain was not a specifieindicator. So the diagnosis of CP should combine the clinic manifestation, laboratory tests, imaging examination, and histology.