胰腺囊性疾病临床诊断分析

Clinical diagnosis of pancreas cystic Lesions： an analysis of 134 cases.

目的探讨胰腺囊性病变（PCL）的发病及诊断方法。方法对经手术或病理证实为胰腺囊性病变的134例患者,从性别、年龄、病程、既往史、伴发症、症状、体征、影像学诊断等方面进行比较分析。结果本研究共收集胰腺假性囊肿（PPC）107例、真性囊肿（TPC）12例、囊性肿瘤（PCT）15例。囊性肿瘤组女性发病率明显高于假性囊肿组（P=0.003）。假性囊肿组有急、慢性胰腺炎史的病例数显著多于真性囊肿和囊性肿瘤组（P值分别为0.000和0.000）,假性囊肿组胆道结石的病例数明显多于囊性肿瘤组（P=0.005）,而真性囊肿组同时伴有肝、肾囊肿的病例数显著高于假性囊肿组（P=0.000）。CT对假性囊肿和囊性恶性肿瘤的诊断准确率高于B超（P值分别为0.000和0.02）。结论胰腺囊性疾病应根据其发病情况、相关病史及影像学特点进行仔细分析,才能有助于明确囊性病变的性质。

Objective To investigate the clinical features and diagnostic methods of pancreas cystic lesions （PCL）. Methods The clinical characteristics of 134 cases of PCL patients confirmed surgically or histologically were analyzed, including age, gender, course of disease, medical history, complications, symptoms, signs and radiological data. Results There were 107 cases of pancreas pseudocyst, 12 cases of true pancreas cyst, and 15 cases of pancreas cystic tumor. There were more female in cystic tumor patients than those in pseudocyst patients （P = 0. 003）. Compared to the true cyst group and the cystic tumor group, more patients among the pseudocyst group reported the history of acute or chronic pancreatitis （P = 0. 000） ; biliary calculi was more frequently discovered among the pseudocyst group than that in the cystic tumor group （P= 0. 005）; liver or/and kidney cyst were more frequently discovered among true cyst group than those among pseudocyst group （P = 0. 000）. CT was more sensitive than abdominal ultrasound in diagnosing pseudocyst （P= 0. 000） and cystic tumor （P = 0.02）. Conclusions To make the correct differential diagnosis of PCL, it＇s important to analyze the clinical features, related history and radiological characteristics carefully.