经手术确诊的158例胰腺癌的诊断分析

Clinical Analysis of 158 Cases with Pancreatic Carcinoma

目的 :探讨胰腺癌的早期临床表现和诊断。方法 :对 1970年元月～ 2 0 0 0年 9月江西医学院第一附属医院资料完整的 2 5 7例胰腺癌住院病例进行回顾性分析。结果 :15 8例经手术确诊 ,其中男性 10 1例 ,女性 5 7例 ,年龄 2 4～ 86岁 ,平均 5 3 .7± 10 .8岁。首发临床症状为 :腹痛 (6 7.7% ) ,黄疸 (13 .3 % ) ,腹胀 (9.5 % ) ,和上腹不适 (5 .3% )。临床症状出现与肿瘤的部位有密切关系 ,食欲不振 ,黄疸 ,乏力和发热多在胰头癌出现 ;消瘦和腰背痛则多在胰体尾癌出现。根治性手术切除 2 5例 ,占 15 .8% ,术中发现有转移者 130例。结论 :临床症状是胰腺癌最重要且最早出现的诊断线索 ,B超。

Objectives:To invedtigate the clinical manifestations and diagnosis of pancreatic carcinoma.Methods:Two hundred and fifty seven cases of pancreatic carcinoma (PC) in this hospital since 1970 were analyzed.Results:Among them,158 patients were diagnosed by operations.101 patients were males and 57 were females.They aged 24～86 years (average 53.7+10.8 years).Initial symptoms included abdominalgia (67.7%),janndice (13.3%),distention (9.5%),and epigastric discomfort (5.3%).The clinical manifestations were related to location of PC.Anorexia,janndice,tired,and fever were the most common symptoms in carcinoma of the head of the pancreas,While magersucht and lumbago likely occurred in cancinoma of the body or trail of pancreas.25 patients were performed oprative excision (15.8%),and metastases were found in 130 patients by surgeons during the operation.Conclusions:The clinical manifestations are the most importent key in the early stage of PC.B-type ultrasonograply,computerized tomography (CT),and endoscopic retrograde cholangio-pancreatography (ERCP) are decisive factors in diagnosis of PC.