254例胰腺癌临床分析

Clinical Analysis of 254 Cases with Pancreatic Carcinoma

目的：胰腺癌发病率呈上升趋势，但早期诊断仍较困难，根治率低。提高对胰腺癌的临床认识，可能对早期诊断有所裨益。方法：采用回顾性分析的方法，分析了１９７７～１９９５年间我院的２５４例胰腺癌病例。结果及结论：男１６６例，女８８例，年龄：２７～８４岁，平均５６９岁。首发症状以腹痛（５０４％）、黄疸（１５４％）、上腹不适（９４％）最常见；病程中的主要症状有腹痛（７２７％）、厌食（７２７％）、消瘦（６８２％）、黄疸（５７０％）、腰背痛（３３１％）。胰腺癌体征主要有腹部压痛（４４２％），肿块（２４４％）；黄疸是胰头癌的突出表现（８６３％），相当一部分是无痛性黄疸。Ｂ超、内镜超声检查、ＣＴ符合率均较高。手术切除率与病程和癌肿大小有关。

Aims:The incidence of pancreatic carcinoma (PC) has an increasing trend.But early diagnosis is still difficult and operative excision rate is low.A better clinical knowledge about PC may be beneficial to its early diagnosis.Methods:By retrospective study(1977～1995),we analysed clinical datas of 254 patients with PC.Results and conclusions:The patients aged 27～84 years (average 56.9 years).166 patients were males and 88 females.Abdominalgia(50.4%)、jaundice(15.4%) or epigastric discomfort (9.4%) were common initial symptoms.Abdominalgia (72.7%)、anorexia(72.7%)、magersucht (68.2%)、jaundice(57.0%) and/or lumbago(33.1%) were often complained during the course of PC.The main signs of PC were tenderness(44.2%) and abdominal mass(24.4%).Jaundice(86.3%) was an eminent presentation in carcinoma of the head of the pancreas and a large part was painless jaundice.B-type ultrasonography,computed tomography and endoscopic ultrasonography all had high positive rate.Operative excision rate was related to the course and the size of PC.Early diagnosis measures were proposed.